Healthcare Provider Details

I. General information

NPI: 1821362757
Provider Name (Legal Business Name): CATHERINE ASHLEY ORYNICH D.M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/23/2012
Last Update Date: 09/16/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8222 E 103RD ST STE 133
TULSA OK
74133-7081
US

IV. Provider business mailing address

4421 DRUID LN
DALLAS TX
75205-1030
US

V. Phone/Fax

Practice location:
  • Phone: 918-970-4944
  • Fax:
Mailing address:
  • Phone: 561-445-8604
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN1855875
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number94
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: