Individual provider Active NPI

Ross Lucas Forrester, D.M.D.

  • Public Health Dentistry
  • Eufaula, OK
National Provider Identifier
1073040358
Registry record updated May 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health DentistryTaxonomy code 1223D0001X
License
D009682 Issued in AZ
Practice address
800 W Forrest Ave
Eufaula, OK 74432-3249
Phone
(918) 448-8399
NPI assigned
May 17, 2017
Last updated
May 17, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 17, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health Dentistry 1223D0001X D009682 AZ Primary

Addresses

Primary practice location

800 W Forrest Ave
Eufaula, OK 74432-3249

Mailing address

P.O. Box 400
Okmulgee, OK 74447-3551
Phone (918) 448-8399

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, TX2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170920003999 OK Practitioner - General PracticePractitioner - Dentist 6002180627 Reassigns benefits to 1 organization
I20210415000650 TX Practitioner - Dentist 6002180627 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D009682AZMDPublic Health Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Forrester Family Dentistry, LLC Current Accepting new patients
Creek Nation Hospital & Clinics Current Accepting new patients
Creek Nation Hospital & Clinics CurrentSince Jan 1, 2021 Accepting new patients
Creek Nation Hospital & Clinics CurrentSince Jul 15, 2017 Accepting new patients
Creek Nation Hospital & Clinics CurrentSince Jul 15, 2017 Accepting new patients

Locations

800 W Forrest Ave
Eufaula, OK 74432
Phone (918) 618-2460

900 E Airport Rd
Okmulgee, OK 74447
Phone 91875643334448

10109 E 79th St
Tulsa, OK 74133
Phone (888) 552-6760

Dept 1467
Tulsa, OK 74182

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1494979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494979200000",
    "number": "1073040358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 400",
            "city": "OKMULGEE",
            "state": "OK",
            "postal_code": "744473551",
            "telephone_number": "918-448-8399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 W FORREST AVE",
            "city": "EUFAULA",
            "state": "OK",
            "postal_code": "744323249",
            "telephone_number": "918-448-8399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORRESTER",
        "first_name": "ROSS",
        "middle_name": "LUCAS",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-05-17",
        "last_updated": "2017-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "AZ",
            "license": "D009682",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eufaula, OK

Sources for this page

Verify at the official NPI Registry.