Active NPI
Kristen Renee' Wolever Campbell, D.D.S
- Dentist
- Norman, OK
National Provider Identifier
1053549014
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 6124
- Practice address
- 420 24TH Ave SW
Norman, OK 73069-1214 - Phone
- (405) 329-6603
- NPI assigned
- Jun 29, 2009
- Sex
- Female
- Sole proprietor
- No
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 | 6124 | OK | Primary |
Addresses
Primary practice location
420 24TH Ave SW
Norman, OK 73069-1214
Mailing address
420 24TH Ave SW
Norman, OK 73069-5110
Phone (405) 329-6603
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 |
|---|---|---|---|---|
| I20151228001550 | OK | Order and Referring Only - Dentist | 4789985284 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6124 | OK | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Norman Smile Center PC | Dentist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Dentist
- Norman, OK
- NPI 1104053339
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1246233600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1386892800000",
"number": "1053549014",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "420 24TH AVE SW",
"city": "NORMAN",
"state": "OK",
"postal_code": "730695110",
"telephone_number": "405-329-6603"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "420 24TH AVE SW",
"city": "NORMAN",
"state": "OK",
"postal_code": "730691214",
"telephone_number": "405-329-6603"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAMPBELL",
"first_name": "KRISTEN",
"middle_name": "RENEE' WOLEVER",
"name_prefix": "Dr.",
"credential": "D.D.S",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-06-29",
"last_updated": "2013-12-13",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "OK",
"license": "6124",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Norman, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2013; 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.