Active NPI
Jamie Horacek
- Dental Hygienist
- Lawton, OK
National Provider Identifier
1013453935
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 2779
- Practice address
- 29 Ketch Creek Cir
Lawton, OK 73507-9030 - Phone
- (580) 442-3905
- NPI assigned
- Jan 17, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 2779 | OK | Primary |
Addresses
Primary practice location
29 Ketch Creek Cir
Lawton, OK 73507-9030
Mailing address
BLDG. 652 Hamilton Rd
USA Dental Activity
Ft. Sill, OK 73503
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 124Q00000X | Other | OK | HYGIENE |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2779 | OK | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1484611200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1484611200000",
"number": "1013453935",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "BLDG. 652 HAMILTON RD",
"address_2": "USA DENTAL ACTIVITY",
"city": "FT. SILL",
"state": "OK",
"postal_code": "73503"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "29 KETCH CREEK CIR",
"city": "LAWTON",
"state": "OK",
"postal_code": "735079030",
"telephone_number": "580-442-3905"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HORACEK",
"first_name": "JAMIE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-01-17",
"last_updated": "2017-01-17",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "OK",
"license": "2779",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HYGIENE",
"identifier": "124Q00000X",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lawton, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.