Provider Type Icon

PREMIERE DENTISTRY OF TAHLEQUAH NPI 1245299825


NPI Information

NPI: 1245299825
Provider Name: PREMIERE DENTISTRY OF TAHLEQUAH
Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

Address:
1205 E ROSS BYPASS
TAHLEQUAH, OK
ZIP 74464
Phone: (918) 456-2555
Get Directions

PREMIERE DENTISTRY OF TAHLEQUAH is a general practice dentist in Tahlequah, OK. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. PREMIERE DENTISTRY OF TAHLEQUAH NPI is 1245299825. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1205 E ROSS BYPASS
TAHLEQUAH, OK
ZIP 74464
Phone: (918) 456-2555
Fax: (918) 456-2444

The provider's authorized official is Robert Stephen Jones .
The authorized official title is Dentist and has the following contact phone number (918) 456-2555.

The enumeration date for this NPI number is 3/21/2006 and was last updated on 4/6/2010.


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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223G0001XDentistGeneral PracticeYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1200021320MEDICAIDOKLAHOMA

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: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.