Dustin Curt Lively, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5327 Issued in OK

Practice address

230 E Jefferson St
Mangum, OK 73554-4202

Phone

(580) 782-2552

Fax

(580) 782-9266

NPI assigned

Jul 28, 2006

Last updated

May 14, 2019By 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

State licenses

Practice roles

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.

• Ez Sleep Solutions, Inc.

  • General Practice Dentistry
  • Mangum, OK
  • NPI 1194295741
  NPD (past) Authorized official
• Shortgrass Community Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Hollis, OK
  • NPI 1255695201
  NPD (past)

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557792000000",
    "number": "1073527933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 126",
            "city": "MANGUM",
            "state": "OK",
            "postal_code": "735540126",
            "telephone_number": "580-782-2552",
            "fax_number": "580-782-9266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 E JEFFERSON ST",
            "city": "MANGUM",
            "state": "OK",
            "postal_code": "735544202",
            "telephone_number": "580-782-2552",
            "fax_number": "580-782-9266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIVELY",
        "first_name": "DUSTIN",
        "middle_name": "CURT",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2019-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OK",
            "license": "5327",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Renee Richelle Klassen, BA.BHRS
• Wendy E. Lamb
• Maria Lara
• Shelly J Larson, CADC
• Angela Little, MS/CCC-SLP
• Benjamin Moses Locklear, D.C.
• Della Logsdon, PRSS
• James Andrew Macrobert, DDS
• Mangum City Hospital Authority (Mangum Regional Medical Center)
• Mangum City Hospital Authority (Mangum Regional Medical Center)

• General Practice Dentistry in Mangum, OK
• Providers in Mangum, 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 May 14, 2019; 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.