SOUTHWEST PEDIATRIC DENTAL ASSOCIATES, PLLC (NPI# 1366568438) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366568438 |
| Entity Type | Organization |
| Organization Name | SOUTHWEST PEDIATRIC DENTAL ASSOCIATES, PLLC |
| Practice Address |
809 Sw 89th St Suite A Oklahoma City OK 73139-9300 |
| Practice Telephone | 4056167336 |
| Practice Fax Number | 4056165756 |
| Mailing Telephone | 4056167336 |
| Mailing Fax Number | 4056165756 |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. THERESA M. WHITE (MANAGER) |
| Authorized Official Telephone | 4056167336 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
4636 | OK | Dental Providers |
| Street Address |
809 SW 89TH ST SUITE A |
| City | OKLAHOMA CITY |
| State | OK |
| Zip Code | 73139-9300 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649252214 | Lucinda Gail Lepley | Nurse Practitioner | 809 Sw 89th St, Ste B, Oklahoma City, OK 73139-9300 | 2005-11-18 |
| 1457910275 | Jake O'bannon | Counselor | 809 Sw 89th St, Oklahoma City, OK 73139-9360 | 2019-06-06 |
| 1992232763 | Shirley Williams | Behavior Technician | 809 Sw 89th St, Suite C, Oklahoma City, OK 73139-9360 | 2017-05-11 |
| 1134426315 | David Lamar Bradshaw | Pathology | 809 Sw 89th St, Ste. C, Oklahoma City, OK 73139-9360 | 2011-02-23 |
| 1861617912 | Lepley Pediatrics | Pediatrics | 809 Sw 89th St, Ste. B, Oklahoma City, OK 73139-9300 | 2007-04-16 |
| 1730205881 | Theresa M. White | Dentist | 809 Sw 89th St, Suite A, Oklahoma City, OK 73139-9300 | 2007-03-21 |
| 1588648976 | Brian Kenneth Lepley | Pediatrics | 809 Sw 89th St, Ste B, Oklahoma City, OK 73139-9300 | 2005-11-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447899778 | First Med Primary Care LLC | Clinic/Center | 1142 Sw 104th St, Oklahoma City, OK 73139 | 2020-01-03 |
| 1205305737 | Transit Medical Team LLC | In Home Supportive Care | 1145 S I-240 Service Rd Ste F, Oklahoma City, OK 73139 | 2018-11-14 |
| 1336621770 | Mayra Edith Solis | Case Manager/Care Coordinator | 6510 S. Western Ave Bldg. 400, Oklahoma City, OK 73139 | 2018-09-01 |
| 1619470184 | Linzi L Stewart, D.o., P.l.l.c. | Obstetrics & Gynecology | 10400 S Western Ave Ste 7, Oklahoma City, OK 73139 | 2018-03-12 |
| 1467970467 | Oklahoma Healthcare Transitions Inc | Home Health | 6803 S Western Ave Ste 400, Oklahoma City, OK 73139 | 2017-08-30 |
| 1841714169 | Gentry Kyler Jones | Case Manager/Care Coordinator | 301 W I240 Service Rd, Oklahoma City, OK 73139 | 2017-07-28 |
| 1437688082 | Jasmine Small | Case Manager/Care Coordinator | 6100 S Walker, Okc, OK 73139 | 2017-06-07 |
| 1689029266 | Swalk Operations, LLC | Skilled Nursing Facility | 315 Sw 80th Street, Oklahoma City, OK 73139 | 2016-05-02 |
| 1225491343 | Elizabeth Pratt | Counselor | 301 Interstate 240 Service Rd, Oklahoma City, OK 73139 | 2016-04-05 |
| 1326418542 | Brittany Elis Walley | Case Manager/Care Coordinator | 8015 S Klein Ave, Oklahoma City, OK 73139 | 2015-09-30 |
| Find all providers in zip 73139 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932684297 | Jemima Poitevien, D.d.s., P.l.l.c. | Dentist | 4225 W Memorial Rd Ste 101-b, Oklahoma City, OK 73134-1761 | 2018-10-02 |
| 1093062911 | Pediatric Dental Partners Pllc | Dentist | 5940 Nw Expressway Ste 200, Oklahoma City, OK 73132-5101 | 2012-08-09 |
| 1508023383 | Thai-an Doan D.d.s. P.C. | Dentist | 11318 N May Ave, Suite B, Oklahoma City, OK 73120-5860 | 2008-05-20 |
| 1619162054 | Robert Brian Molloy | Dentist | 9801 S Pennsylvania Ave, Oklahoma City, OK 73159-6925 | 2007-09-10 |
| 1467574004 | Smiling Faces Pediatric Dentistry Inc | Dentist | 5222 N. Portland, Oklahoma City, OK 73112 | 2007-04-04 |
| 1760521934 | Elizabeth Kellner | Dentist | 828 Sw 66th St, Oklahoma City, OK 73139-4213 | 2007-02-05 |
| 1194828558 | Thai-an Doan | Dentist | 14228 Barbour Ave, Oklahoma City, OK 73134 | 2006-09-07 |
| 1780618330 | Andrew Cleveland Guthrie | Dentist | 3616 Nw 50th St, Oklahoma City, OK 73112-5642 | 2006-07-10 |
| 1558318493 | Donald Wood Haskins | Dentist | 5222 N Portland Ave, Oklahoma City, OR 73112 | 2006-05-27 |
| 1720063225 | William G Bozalis | Dentist | 3613 Nw 56th, Suite 105 Three Corporate Plaza, Oklahoma City, OK 73112 | 2005-12-07 |
| Find all providers in OKLAHOMA CITY | ||||
| City | OKLAHOMA CITY |
| Zip Code | 73139 |
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| 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.