PAWNEE DENTAL CLINIC (NPI# 1548565070) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548565070 |
| Entity Type | Organization |
| Organization Name | PAWNEE DENTAL CLINIC |
| Practice Address |
622 7th St Pawnee OK 74058-2541 |
| Practice Telephone | 9187623501 |
| Practice Fax Number | 9187622600 |
| Mailing Telephone | 9187623501 |
| Mailing Fax Number | 9187622600 |
| Enumeration Date | 2011-01-13 |
| Last Update Date | 2011-01-13 |
| Authorized Official Name | DR. GARY STARK HENDERSON (DENTIST) |
| Authorized Official Telephone | 9187623501 |
| 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 |
3796 | OK | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 100053630A | 05 |
| Street Address |
622 7TH ST |
| City | PAWNEE |
| State | OK |
| Zip Code | 74058-2541 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265473714 | Gary Stark Henderson | Dentist | 622 7th St, Pawnee, OK 74058-2541 | 2006-06-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316214430 | Tonya L Houston | Nurse Practitioner | Pawnee Indian Health Center, 1201 Heritage Cir, Pawnee, OK 74058 | 2011-11-17 |
| 1659662153 | Christie Factor | Counselor | 540 Illinois, Pawnee, OK 74058 | 2011-05-02 |
| 1366476368 | Henry J Kaehler Jr Dds PC | Clinic/Center | 401 Forest St, Pawnee, OK 74058 | 2006-07-10 |
| 1003892621 | Brady Gene Englestead | Pediatrics | 1201 Heritage Circle, Pawnee, OK 74058 | 2005-12-15 |
| 1598039620 | Cah Acquisition Company 12 LLC | Clinic/Center | 535 6th St, Pawnee, OK 74058 | 2012-03-07 |
| 1639453665 | Creoks Mental Health Services | Community/Behavioral Health | 540 Illinois St, Pawnee, OK 74058 | 2011-10-10 |
| 1659473080 | Henry John Kaehler Jr. | Dentist | 401 Forest St, Pawnee, OK 74058 | 2006-09-05 |
| 1578503611 | William Lester Carruth | Dentist | 481 Agency Road, Pawnee, OK 74058-0130 | 2006-06-07 |
| 1821275744 | Patsy Ann Cooper | Counselor | 540 Illinois St, Pawnee, OK 74058-2036 | 2008-01-22 |
| 1225158314 | Cockrell Eyecare Center | Optometrist | 534 Illinois St, Pawnee, OK 74058-2036 | 2007-03-30 |
| Find all providers in zip 74058 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
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|---|---|---|---|---|
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| 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 | ||||
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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.