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HENYRETTA DENTAL CENTER 2 PLLC NPI 1750660700


NPI Information

NPI: 1750660700
Provider Name: HENYRETTA DENTAL CENTER 2, PLLC

Former Legal Business Name: HENRYETTA DENTAL CENTER, PLLC

Classification: Clinic/Center - 261QD0000X
Entity Type: Organization

Specialization: Dental

Address:
121 S 6TH ST
HENRYETTA, OK
ZIP 74437
Phone: (918) 652-2555
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HENYRETTA DENTAL CENTER 2, PLLC is a dental clinic center in Henryetta, OK. HENYRETTA DENTAL CENTER 2, PLLC NPI is 1750660700. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Henryetta Dental Center, Pllc.

The provider's business location address is:

121 S 6TH ST
HENRYETTA, OK
ZIP 74437-009
Phone: (918) 652-2555
Fax: (918) 652-2556

The provider's authorized official is Jeremy Scott Johnson .
The authorized official title is Dentist and has the following contact phone number 98186522555.

The enumeration date for this NPI number is 8/9/2011 and was last updated on 8/9/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QD0000XClinic/CenterDental5868OKLAHOMAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1200085770AMEDICAIDOKLAHOMA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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