Individual provider Active NPI

Angela J Rhodes, D.D.S

  • Dentist
  • Broken Arrow, OK
National Provider Identifier
1083062004
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
6828 Issued in OK
Practice address
2311 N 9TH St Ste 102
Broken Arrow, OK 74012-2887
Phone
(918) 994-2100
Fax
(918) 994-2101
NPI assigned
May 31, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 6828 OK Primary

Addresses

Primary practice location

2311 N 9TH St Ste 102
Broken Arrow, OK 74012-2887

Mailing address

2311 N 9TH St Ste 102
Broken Arrow, OK 74012-2887
Phone (918) 994-2100

Other practice location 1

530 Plaza Ct
Sand Springs, OK 74063-7915
Phone (918) 629-3810

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6828OKMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Inspire Dental PLLC 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.

NPI Registry JSON

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

{
    "created_epoch": "1464652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1083062004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2311 N 9TH ST STE 102",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740122887",
            "telephone_number": "918-994-2100",
            "fax_number": "918-994-2101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2311 N 9TH ST STE 102",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740122887",
            "telephone_number": "918-994-2100",
            "fax_number": "918-994-2101"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "530 Plaza Ct",
            "address_purpose": "LOCATION",
            "city": "Sand Springs",
            "state": "OK",
            "postal_code": "740637915",
            "country_code": "US",
            "telephone_number": "918-629-3810",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RHODES",
        "first_name": "ANGELA",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-31",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OK",
            "license": "6828",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Broken Arrow, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.