Active NPI
Andrea Matli Scoville, DDS
- Dentist
- Watonga, OK
National Provider Identifier
1215150693
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 4530
- Practice address
- 601 W 2ND Street
Watonga, OK 73772-2601 - Phone
- (580) 623-7121
- Fax
- (580) 623-7124
- NPI assigned
- Apr 11, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 4530 | OK | Primary |
Addresses
Primary practice location
601 W 2ND Street
Watonga, OK 73772-2601
Mailing address
601 W 2ND Street
Watonga, OK 73772-2601
Phone (580) 623-7121
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176249600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1471996800000",
"number": "1215150693",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "601 W 2ND STREET",
"city": "WATONGA",
"state": "OK",
"postal_code": "737722601",
"telephone_number": "580-623-7121",
"fax_number": "580-623-7124"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "601 W 2ND STREET",
"city": "WATONGA",
"state": "OK",
"postal_code": "737722601",
"telephone_number": "580-623-7121",
"fax_number": "580-623-7124"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCOVILLE",
"first_name": "ANDREA",
"middle_name": "MATLI",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-11",
"last_updated": "2016-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "OK",
"license": "4530",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Watonga, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.