Individual provider Active NPI

John L Sjulin, DDS

  • General Practice Dentistry
  • Ardmore, OK
National Provider Identifier
1154363075
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3801 Issued in OK
Practice address
808 16TH Ave NW
Ardmore, OK 73401-1818
Phone
(580) 226-2822
Fax
(580) 226-7561
NPI assigned
Jun 12, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 3801 OK Primary

Addresses

Primary practice location

808 16TH Ave NW
Ardmore, OK 73401-1818

Mailing address

808 16TH Ave NW
Ardmore, OK 73401-1818
Phone (580) 226-2822

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
3801OKMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154363075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "808 16TH AVE NW",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734011818",
            "telephone_number": "580-226-2822",
            "fax_number": "580-226-7561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "808 16TH AVE NW",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734011818",
            "telephone_number": "580-226-2822",
            "fax_number": "580-226-7561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SJULIN",
        "first_name": "JOHN",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OK",
            "license": "3801",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ardmore, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.