PARKS FAMILY DENTAL (NPI# 1316210768) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316210768 |
| Entity Type | Organization |
| Organization Name | PARKS FAMILY DENTAL |
| Practice Address |
1520 East Main Street Tishomingo OK 73460 |
| Practice Telephone | 5803713900 |
| Practice Fax Number | 5803713903 |
| Mailing Telephone | 5803713900 |
| Mailing Fax Number | 5803713903 |
| Enumeration Date | 2012-02-15 |
| Last Update Date | 2012-02-15 |
| Authorized Official Name | DR. JUSTIN RAY PARKS (DENTIST) |
| Authorized Official Telephone | 5803713900 |
| Authorized Official Credential | D.D.S. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
1124 | OK | Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265704183 | Parks Family Dental | Preferred Provider Organization | 1520 E. Main Street, Tishomingo, OK 73460 | 2012-02-08 |
| 1659865905 | Parks Family Dental | Clinic/Center | 100 Professional Ct, Mauldin, SC 29662-3257 | 2018-06-20 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oklahoma Business Registrations | PARKS FAMILY DENTAL, P.C. | 1520 E Hwy 78, Tishomingo, OK 73460 |
| Street Address |
1520 EAST MAIN STREET |
| City | TISHOMINGO |
| State | OK |
| Zip Code | 73460 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912380742 | Lori Pigg | Speech-Language Pathologist | 508 N. Neshoba, Tishomingo, OK 73460 | 2015-06-29 |
| 1407241748 | Brittany Walker | Case Management | 850 E. Highway 22, Tishomingo, OK 73460 | 2015-04-03 |
| 1427460641 | Elizabeth Mcdonald | Counselor | 512 East 24th, Tishomingo, OK 73460 | 2014-05-22 |
| 1619387131 | Sheri Slaughter | Counselor | 102 N. Neshoba, Tishomingo, OK 73460 | 2014-05-06 |
| 1336559848 | Heather Marlatt | Counselor | 102 North Neshoba, Tishomingo, OK 73460 | 2014-05-06 |
| 1811231939 | Wanda Luann Beesley Gray | Emergency Medical Technician, Paramedic | 3100 E St Hwy 78, Tishomingo, OK 73460 | 2012-11-15 |
| 1497014724 | Jessica Kay Johnston | Counselor | Outpatient Services-tishomingo; 817 E. 6th St., Strong Family Development, Tishomingo, OK 73460 | 2012-05-07 |
| 1487910949 | Rhonda Gayle Harrison | Counselor | 817 E. 6th St., Medical Family Therapy, Tishomingo, OK 73460 | 2012-04-09 |
| 1265704183 | Parks Family Dental | Preferred Provider Organization | 1520 E. Main Street, Tishomingo, OK 73460 | 2012-02-08 |
| 1770852295 | Gina Marice Frazier | Social Worker | Outpatient Services- Tishomingo, 817 E. 6th St., Tishomingo, OK 73460 | 2011-12-29 |
| Find all providers in zip 73460 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609474758 | Sand Springs Dentistry and Braces | Clinic/Center | 152 W. Alexander Blvd, Ste E, Sand Springs, OK 74063 | 2020-10-12 |
| 1831796580 | Perry Smiles LLC | Clinic/Center | 505 N 14th St Ste B, Perry, OK 73077-5000 | 2020-10-06 |
| 1518578095 | Summer Dental Midwest City, Pllc | Clinic/Center | 1900 S Air Depot Blvd Ste 1, Midwest City, OK 73110-5522 | 2020-08-10 |
| 1922626639 | Dental Lodge of Purcell | Clinic/Center | 1929 S Green Ave, Purcell, OK 73080-6203 | 2020-07-09 |
| 1821616533 | Enhance Dental of Norman | Clinic/Center | 1049 12th Ave Ne # 100, Norman, OK 73071-5312 | 2020-07-09 |
| 1164049185 | Custom Dental of Yukon, Pllc | Clinic/Center | 4425 Grant Blvd, Yukon, OK 73099 | 2020-06-26 |
| 1720600174 | Piedmont Dentistry & Braces | Clinic/Center | 12000 Nw Expressway, Yukon, OK 73099 | 2020-05-08 |
| 1073135588 | Yukon Dentistry & Braces | Clinic/Center | 901 E Main Street, Suite 100, Yukon, OK 73099 | 2020-05-07 |
| 1265052062 | Ada Dentistry and Braces | Clinic/Center | 931 Arlington St Ste 3, Ada, OK 74820-4025 | 2020-04-21 |
| 1225657133 | Impressions Dental of Harrah | Clinic/Center | 20926 Se 29th St Ste A, Harrah, OK 73045-6610 | 2020-04-10 |
| Find all providers with the same taxonomy | ||||
| City | TISHOMINGO |
| Zip Code | 73460 |
Please comment or provide details below to improve the information on PARKS FAMILY DENTAL.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.