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Contact Information

KINGFISHER DENTAL PLLC
100 STARLITE DR
KINGFISHER, OK73750
 Phone: 405-375-5855
 Fax: 405-358-2946
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for KINGFISHER DENTAL PLLC

NPI # 1992849996
LBN Legal business name KINGFISHER DENTAL PLLC
Authorized official BENJAMIN BOWMAN - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 02/16/2007
Last updated 02/15/2021 - About 5 years ago
Identifiers
OK License # 3767
OK Medicaid 200208490A
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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