Michael Bennett, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

7543 Issued in OK

Practice address

3703 N Kickapoo Ave
Shawnee, OK 74804-1703

Phone

(405) 275-0640

Fax

(405) 225-3008

NPI assigned

Apr 28, 2022

Last updated

Apr 28, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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.

• Summer Dental Shawnee PLLC

  • Dentist
  • Shawnee, OK
  • NPI 1548834872
  NPD
• Summer Dental Midwest City, PLLC

  • General Practice Dentistry
  • Midwest City, OK
  • NPI 1518578095
  NPD (past)
• Tecumseh Family Dentistry PLLC

  • Dental Clinic/Center
  • Tecumseh, OK
  • NPI 1912731936
  NPD (past)

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

{
    "created_epoch": "1651104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651104000000",
    "number": "1073258786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 RIVERWALK TER STE 250",
            "city": "JENKS",
            "state": "OK",
            "postal_code": "740375619",
            "telephone_number": "918-998-0996",
            "fax_number": "918-235-9079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3703 N KICKAPOO AVE",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "748041703",
            "telephone_number": "405-275-0640",
            "fax_number": "405-225-3008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "MICHAEL",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-28",
        "last_updated": "2022-04-28",
        "certification_date": "2022-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OK",
            "license": "7543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marilyn A. Becker, NP
• Troy Thomas Becker
• Behavioral Medicine Associates, Inc.
• Rachel Beiermann
• Lyric Bell, MFT- CANDIDACY
• Richard Dean Bennett
• Taylor Faith Bennett
• Jordan Benson
• Annette Bentley
• Bethel Public Schools

• General Practice Dentistry in Shawnee, OK
• Providers in Shawnee, OK by specialty
• General Practice Dentistry in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2022; 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.