Active NPI
Kristie Lynn Vinson, DDS
- Dentist
- Tulsa, OK
National Provider Identifier
1023379930
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 6413
- Practice address
- 5119 E 81St St
Tulsa, OK 74137 - Phone
- (918) 492-1917
- NPI assigned
- Jun 6, 2012
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 6413 | OK | Primary |
Addresses
Primary practice location
5119 E 81St St
Tulsa, OK 74137
Mailing address
5119 E. 81St St
Tulsa, OK 74137
Phone (918) 492-1917
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OK
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160404000851 | OK | Order and Referring Only - Dentist | 5092012286 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1338940800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1610064000000",
"number": "1023379930",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5119 E. 81ST ST",
"city": "TULSA",
"state": "OK",
"postal_code": "74137",
"telephone_number": "918-492-1917"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5119 E 81ST ST",
"city": "TULSA",
"state": "OK",
"postal_code": "74137",
"telephone_number": "918-492-1917"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VINSON",
"first_name": "KRISTIE",
"middle_name": "LYNN",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-06-06",
"last_updated": "2021-01-08",
"certification_date": "2021-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "OK",
"license": "6413",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tulsa, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.