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Active NPI 1093329260 Individual Practitioner Male Practitioner

Dr. Jonathan Chu-Ming Soetandio , DMD

Dentist - General Practice • Tulsa, OK

Professional Overview & Biography Verified Profile Summary

Dr. Jonathan Soetandio, DMD is a registered healthcare professional specializing in Dentist - General Practice in Tulsa, OK. Practice services are available at 5510 E 41ST ST STE C under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

5510 E 41st St Ste C

Tulsa, OK 741356009

Telephone 9186414635
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Tulsa, OK

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 28.5 Yrs
State Avg: 17.8 Yrs
Regional Practice Density
187 Specialists

Practicing in Tulsa, OK (1496 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2021-12-14
Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License TX 37917

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Dentist

NUCC Taxonomy Code: 122300000X

State License OK 7387

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

Secondary Practice Locations

215 S Loop 336 W

Conroe, TX 773043305

Phone: 9362701294

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

3 Associated Practitioners
Dr. Sebastian Gutierrez De Pineres , DDS, MD

Dentist - Oral and Maxillofacial Surgery

NPI 1003314329

Doctor of Dental Surgery, Doctor of Medicine (M.D.)

NPI 1730792714

Doctor of Dental Surgery

Dr. Amy John , DDS

Dentist - General Practice

NPI 1912744129

Doctor of Dental Surgery

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
📍
Updated Business Mailing Address December 14, 2021

Registered at 215 S LOOP 336 W, CONROE, TX 773043305

NPI Profile Active September 03, 2020

NPI status registered as active in NPPES database

📍
Updated Practice Location September 03, 2020

Registered at 5510 E 41ST ST STE C, TULSA, OK 741356009 (Tel: 9186414635)

📍
Updated Business Mailing Address September 03, 2020

Registered at 7937 E 27TH CT, TULSA, OK 741292434 (Tel: 2817962343)

👤
Provider Name / Credentials Updated September 03, 2020

Recorded as JONATHAN SOETANDIO, DMD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 03, 2020

Dentist (License #7387 in OK)

🟢
Initial NPI Registration & Enumeration September 03, 2020

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1093329260
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 03, 2020
Last Update: December 14, 2021
Sole Proprietor: No

Mailing Address

215 S Loop 336 W

Conroe, TX 773043305

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.