Individual provider Active NPI

Steven D Gulbranson, DDS

  • Dentist
  • Wichita Falls, TX
National Provider Identifier
1205807633
Registry record updated Jan 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
17482 Issued in TX
Practice address
200 Martin Luther King Blvd
Wichita Falls, TX 76301-1152
Phone
(940) 766-6306
Fax
(940) 766-6504
NPI assigned
Feb 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 17482 TX Primary

Addresses

Primary practice location

200 Martin Luther King Blvd
Wichita Falls, TX 76301-1152

Mailing address

200 Martin Luther King Blvd
Wichita Falls, TX 76301-1152
Phone (940) 766-6306

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
17482TXMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1138752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389139200000",
    "number": "1205807633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MARTIN LUTHER KING BLVD",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763011152",
            "telephone_number": "940-766-6306",
            "fax_number": "940-766-6504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MARTIN LUTHER KING BLVD",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763011152",
            "telephone_number": "940-766-6306",
            "fax_number": "940-766-6504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GULBRANSON",
        "first_name": "STEVEN",
        "middle_name": "D",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-01",
        "last_updated": "2014-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "17482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita Falls, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2014; 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.