| Board Of Regents Of The University Of Oklahoma - Ou Denitstry | |
|
1201 N Stonewall Room 494 Oklahoma City OK 73117-1214 | |
| (405) 271-5714 | |
| (405) 271-2405 |
| Full Name | Board Of Regents Of The University Of Oklahoma - Ou Denitstry |
|---|---|
| Speciality | Dentist |
| Location | 1201 N Stonewall, Oklahoma City, Oklahoma |
| Authorized Official Name and Position | D. Michelle Park (DIRECTOR) |
| Authorized Official Contact | 4052718001 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Board Of Regents Of The University Of Oklahoma - Ou Denitstry Po Box 528802-8802 Oklahoma City OK 73152-8802 Ph: (405) 271-5714 | Board Of Regents Of The University Of Oklahoma - Ou Denitstry 1201 N Stonewall Room 494 Oklahoma City OK 73117-1214 Ph: (405) 271-5714 |
| NPI Number | 1629110119 |
|---|---|
| Provider Enumeration Date | 02/13/2007 |
| Last Update Date | 01/06/2014 |
| Medicare PECOS PAC ID | 9436104346 |
|---|---|
| Medicare Enrollment ID | O20050314000819 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629110119 | NPI | - | NPPES |
| 100745050A | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
| Provider Name | David Lewis |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1760451256 PECOS PAC ID: 6305851494 Enrollment ID: I20060210000235 |
| Provider Name | Paul M Mullasseril |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1164585519 PECOS PAC ID: 0749337293 Enrollment ID: I20090421000484 |
| Provider Name | Stephen K Young |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1922077361 PECOS PAC ID: 4880686328 Enrollment ID: I20100521000696 |
| Provider Name | Andrew Goldbeck |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1104927359 PECOS PAC ID: 0941488720 Enrollment ID: I20110627000209 |
| Provider Name | Susan L Settle |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1881769875 PECOS PAC ID: 6305014697 Enrollment ID: I20110712000152 |
| Provider Name | Robert E Carson |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1679648703 PECOS PAC ID: 2769650910 Enrollment ID: I20110714000414 |
| Provider Name | Yacoub Al Sakka |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1568862357 PECOS PAC ID: 9436466836 Enrollment ID: I20150917001227 |
| Provider Name | Tapan Koticha |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1497023196 PECOS PAC ID: 3870879976 Enrollment ID: I20170403002455 |
| Provider Name | Ronald C Faram |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1689929184 PECOS PAC ID: 7719279058 Enrollment ID: I20210122001890 |
| Provider Name | Kathleen E Higgins |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1710413091 PECOS PAC ID: 3476984881 Enrollment ID: I20211011002754 |
| Provider Name | Farah Masood |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1730283870 PECOS PAC ID: 1759694821 Enrollment ID: I20230119002027 |
Dental Works Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 4200 Hemingway Dr, Oklahoma City, OK 73118 Phone: 405-557-1245 | |
Wm Edward Holcomb Dds Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 6303 North Portland Ave #209, Oklahoma City, OK 73112 Phone: 405-942-7771 Fax: 405-942-7796 | |
Gregory S. Shanbour, D.d.s., M.s. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 8117 S Walker Ave, Oklahoma City, OK 73139 Phone: 405-634-2239 Fax: 405-634-3598 | |
Neighborhood Services Organization Inc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 431 Sw 11th Street, Oklahoma City, OK 73109 Phone: 405-236-0413 Fax: 405-236-1871 | |
Heather Cox Dds Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 5701 N Portland Ave, Suite 121, Oklahoma City, OK 73112 Phone: 405-604-6400 Fax: 405-604-4229 | |
Dental Depot 62nd & South Western Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 6217 S Western Ave, Oklahoma City, OK 73139 Phone: 405-606-7123 Fax: 405-606-7130 | |
Kelly Klontz Dds,pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 9721 S Pennsylvania Ave, Oklahoma City, OK 73159 Phone: 405-691-8100 |