Active NPI
Austin Michael Neil, D.D.S.
- General Practice Dentistry
- Kingfisher, OK
National Provider Identifier
1164081949
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 7202
- Practice address
- 100 Starlite Dr
Kingfisher, OK 73750-4944 - Phone
- (405) 375-5855
- NPI assigned
- Jun 6, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 7202 | OK | Primary |
Addresses
Primary practice location
100 Starlite Dr
Kingfisher, OK 73750-4944
Mailing address
1625 NW 145TH St
Edmond, OK 73013-1742
Phone (918) 312-1824
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
| License | State | Type | Specialty |
|---|---|---|---|
| 7202 | OK | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kingfisher Dental PLLC | General Practice | 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": "1559779200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1588723200000",
"number": "1164081949",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1625 NW 145TH ST",
"city": "EDMOND",
"state": "OK",
"postal_code": "730131742",
"telephone_number": "918-312-1824"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 STARLITE DR",
"city": "KINGFISHER",
"state": "OK",
"postal_code": "737504944",
"telephone_number": "405-375-5855"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NEIL",
"first_name": "AUSTIN",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-06-06",
"last_updated": "2020-05-06",
"certification_date": "2020-05-06",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "OK",
"license": "7202",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kingfisher, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.