Individual provider Active NPI

James Michael Willbanks, D.D.S.

  • Dentist
  • Oklahoma City, OK
National Provider Identifier
1184704231
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
4637 Issued in OK
Practice address
2209 SW 74TH St
Suite 315
Oklahoma City, OK 73159-3929
Phone
(405) 688-2500
NPI assigned
Oct 16, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

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
Dentist 122300000X 4637 OK Primary

Addresses

Primary practice location

2209 SW 74TH St
Suite 315
Oklahoma City, OK 73159-3929

Mailing address

2209 SW 74TH St
Suite 315
Oklahoma City, OK 73159-3929

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160628002057 OK Order and Referring Only - DentistPractitioner - Dentist 1254622855

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4637OKMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Affordable Dentures & Implants - Oklahoma, PLLC Dentist 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184704231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2209 SW 74TH ST",
            "address_2": "SUITE 315",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731593929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2209 SW 74TH ST",
            "address_2": "SUITE 315",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731593929",
            "telephone_number": "405-688-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLBANKS",
        "first_name": "JAMES",
        "middle_name": "MICHAEL",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OK",
            "license": "4637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.