Individual provider Active NPI

Dan Eldon Patterson, D.D.S.

  • Oral and Maxillofacial Surgery (Dentist)
  • Tulsa, OK
National Provider Identifier
1053306142
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
3668 Issued in OK
Practice address
9118 S Toledo Ave
Tulsa, OK 74137-2700
Phone
(918) 495-1800
Fax
(918) 495-1890
NPI assigned
Sep 14, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 3668 OK Primary

Addresses

Primary practice location

9118 S Toledo Ave
Tulsa, OK 74137-2700

Mailing address

3606 W Vista LN
Stillwater, OK 74074-7602
Phone (405) 624-8864

Other identifiers 1

IdentifierTypeStateIssuer
681024OtherOKUNITED CONCORDIA ID #

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
3668OKMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Ashton Creek Oral Surgery Suites, P.L.L.C. PastSince Jan 1, 1990 Accepting new patients
Central Oklahoma Oral & Maxillofacial Surgery Associates of Tulsa, PC Past Accepting new patients
Central Oklahoma Oral & Maxillofacial Surgery Associates Oral and Maxillofacial Surgery Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1126656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1053306142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3606 W VISTA LN",
            "city": "STILLWATER",
            "state": "OK",
            "postal_code": "740747602",
            "telephone_number": "405-624-8864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9118 S TOLEDO AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741372700",
            "telephone_number": "918-495-1800",
            "fax_number": "918-495-1890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATTERSON",
        "first_name": "DAN",
        "middle_name": "ELDON",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-14",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "OK",
            "license": "3668",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA ID #",
            "identifier": "681024",
            "state": "OK"
        }
    ],
    "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 Jul 13, 2026; 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.