ENID DENTISTRY & BRACES NPI 1780105122

NPI Information

NPI: 1780105122
Provider Name: ENID DENTISTRY & BRACES
Classification: Clinic/Center - 261QD0000X
Entity Type: Organization

Specialization: Dental

Address:
5202 W OWEN K GARRIOTT RD STE A
ENID, OK
ZIP 73703
Phone: (580) 242-5862
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ENID DENTISTRY & BRACES is a dental clinic center in Enid, OK. ENID DENTISTRY & BRACES NPI is 1780105122. The provider is registered as an organization entity type.

The provider's business location address is:

5202 W OWEN K GARRIOTT RD STE A
ENID, OK
ZIP 73703-611
Phone: (580) 242-5862

The provider's authorized official is Benjamin James Bowman .
The authorized official title is Manager and has the following contact phone number (405) 326-8004.

The enumeration date for this NPI number is 7/6/2017 and was last updated on 12/4/2023.

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
1	261QD0000X	Clinic/Center	Dental	6076	OKLAHOMA	Yes

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
1	1205032935	MEDICAID	OKLAHOMA

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

NPI Synchronization or Removal

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