Provider Demographics
NPI:1821362757
Name:ORYNICH, CATHERINE ASHLEY (DMD)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:ASHLEY
Last Name:ORYNICH
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4421 DRUID LN
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75205-1030
Mailing Address - Country:US
Mailing Address - Phone:561-445-8604
Mailing Address - Fax:
Practice Address - Street 1:8222 E 103RD ST
Practice Address - Street 2:STE 133
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74133-7081
Practice Address - Country:US
Practice Address - Phone:918-970-4944
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-23
Last Update Date:2014-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN1855875122300000X
OK941223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223P0221XDental ProvidersDentistPediatric Dentistry