Laurie Lynn Southard, BS, MS, DDS

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

5119 Issued in OK

Practice address

5010 E 68TH St
Suite 104
Tulsa, OK 74136-3323

Phone

(918) 493-3880

Fax

(918) 492-8564

NPI assigned

Mar 26, 2007

Sex

Female

Sole proprietor

Yes

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.

• Johnson and Southard Endodontics

  • Endodontics
  • Tulsa, OK
  • NPI 1649416876
  NPD (past) Authorized official

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jun 28, 2016 through Jun 28, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Science, Master of Science

Practice roles

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

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457395200000",
    "number": "1215054820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5010 E 68TH ST",
            "address_2": "SUITE 104",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741363323",
            "telephone_number": "918-493-3880",
            "fax_number": "918-492-8564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5010 E 68TH ST",
            "address_2": "SUITE 104",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741363323",
            "telephone_number": "918-493-3880",
            "fax_number": "918-492-8564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUTHARD",
        "first_name": "LAURIE",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "BS, MS, DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-26",
        "last_updated": "2016-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "OK",
            "license": "5119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• South Wind Women'S Center
• Skylar Southall
• Southard Family Dental, LLC
• Denny W Southard, DDS
• Kinsley Southard
• Wrany R Southard, D.D.S., P.C.
• Southbrook Family Physicians PLLC
• Southcrest Anesthesia Group LLC
• Southcrest Dialysis LLC
• Southcrest Emergency Physicians PC

• All providers in Tulsa, OK
• Endodontics in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.