Individual provider Active NPI

Mark Darrin Unruh, D.D.S., M.S.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Bartlesville, OK
National Provider Identifier
1003006024
Registry record updated Jul 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
5338 Issued in OK
Practice address
425 S Madison Blvd
Bartlesville, OK 74006-2826
Phone
(918) 333-3628
NPI assigned
Jul 26, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 26, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 5338 OK Primary

Addresses

Primary practice location

425 S Madison Blvd
Bartlesville, OK 74006-2826

Mailing address

425 S Madison Blvd
Bartlesville, OK 74006-2826
Phone (918) 333-3628

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
5338OKMDMental Health Counselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1185408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185408000000",
    "number": "1003006024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 S MADISON BLVD",
            "city": "BARTLESVILLE",
            "state": "OK",
            "postal_code": "740062826",
            "telephone_number": "918-333-3628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 S MADISON BLVD",
            "city": "BARTLESVILLE",
            "state": "OK",
            "postal_code": "740062826",
            "telephone_number": "918-333-3628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UNRUH",
        "first_name": "MARK",
        "middle_name": "DARRIN",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-26",
        "last_updated": "2007-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "OK",
            "license": "5338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bartlesville, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.