DENTAL DEPOT SOUTHERN HILLS 71ST & JACKSON (NPI# 1407412992) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407412992 |
| Entity Type | Organization |
| Organization Name | DENTAL DEPOT SOUTHERN HILLS 71ST & JACKSON |
| Practice Address |
710 W. 74th Street Tulsa OK 74132 |
| Practice Telephone | 9182367123 |
| Practice Fax Number | 9189980818 |
| Mailing Telephone | 9182367123 |
| Mailing Fax Number | 9189980818 |
| Enumeration Date | 2019-05-10 |
| Last Update Date | 2019-05-10 |
| Authorized Official Name | DR. GLENN ALLAN ASHMORE (OWNER / PRESIDENT) |
| Authorized Official Telephone | 9182367123 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 100088170A | 05 |
| Street Address |
710 W. 74TH STREET |
| City | TULSA |
| State | OK |
| Zip Code | 74132 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265971717 | Tulsa Micro Hospital, LLC | General Acute Care Hospital | 717 West 71st Street, Tulsa, OK 74132 | 2017-02-16 |
| 1467715300 | Mednow Urgent Care Center LLC | Emergency Medicine | 7127 S Olympia, Tulsa, OK 74132 | 2012-06-15 |
| 1801153754 | Jeffrey B Hill | Family Medicine | 7858 South Olympia Avenue West, Tulsa, OK 74132 | 2012-04-17 |
| 1871733519 | Mjr Enterprises LLC | Family Medicine | 3800 W. 71st, Inverness Village, Tulsa, OK 74132 | 2009-02-20 |
| 1356331052 | Trisza L Ray | Family Medicine | 7858 South Olympia Avenue, Tulsa, OK 74132 | 2005-10-24 |
| 1245229657 | Bruce E Hudkins | Otolaryngology | 6802 S Olympia Ave West, Ste 200, Tulsa, OK 74132 | 2005-10-18 |
| 1306843248 | Paul Pisarik | Family Medicine | 7858 S Olympia Ave, Tulsa, OK 74132 | 2005-07-07 |
| 1235752361 | William Richey | Pharmacist | 6901 S Olympia Ave, Tulsa, OK 74132 | 2020-05-23 |
| 1508424755 | Tulsa Ep, Pllc | Emergency Medicine | 717 W. 71st Street, Tulsa, OK 74132 | 2019-06-03 |
| 1659864379 | Gina Matlock | Nurse Practitioner | 7858 S Olympia Ave, Tulsa, OK 74132 | 2018-06-07 |
| Find all providers in zip 74132 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386897684 | Kids Dental | Clinic/Center | 10346 E 21st St, Tulsa, OK 74129-1606 | 2008-10-30 |
| 1407056583 | Thomas H. Gilbert Dds, Inc | Clinic/Center | 7116 S Mingo Rd Ste 112, Tulsa, OK 74133-3268 | 2007-07-18 |
| 1689613028 | Myron E. Katz, Dmd, Msd, Inc | Clinic/Center | 4543 S Harvard Ave, Tulsa, OK 74135-2905 | 2006-06-04 |
| 1457353278 | Mark M. Davis, D.d.s., PC | Clinic/Center | 5301 S Lewis Ave, Tulsa, OK 74105-6539 | 2005-08-11 |
| 1225653280 | Henrich Dental Office | Clinic/Center | 7905 E 106th St, Tulsa, OK 74133-6802 | 2020-06-15 |
| 1568097590 | Dental Masterpieces Pllc | Clinic/Center | 3920 E 91st St, Tulsa, OK 74137-3602 | 2020-03-10 |
| 1518414523 | Smile Stop Dental of Soutwest Tulsa | Clinic/Center | 5676 W Skelly Dr Ste A, Tulsa, OK 74107-9134 | 2016-09-07 |
| 1083090229 | Ipa Tulsa Pllc | Clinic/Center | 6565 S Yale Ave, Suite 505, Tulsa, OK 74136-8327 | 2015-08-10 |
| 1790198232 | Lindsay A. Smith, D.d.s., P.l.l.c. | Clinic/Center | 2538 E 21st St, Tulsa, OK 74114-1700 | 2014-06-03 |
| 1548501133 | Tulsa Dental Implants and Periodontics | Clinic/Center | 9607 E 95th Ct S, Tulsa, OK 74133-5839 | 2013-03-07 |
| Find all providers in TULSA | ||||
Please comment or provide details below to improve the information on DENTAL DEPOT SOUTHERN HILLS 71ST & JACKSON.
| 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.