Active NPI
Lesley Ann Maxwell, D.D.S.
- Dentist
- Tulsa, OK
National Provider Identifier
1225349400
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 6199
- Practice address
- 7104 S Sheridan Rd
Suite #8
Tulsa, OK 74133-2770 - Phone
- (918) 492-1917
- Fax
- (918) 492-4538
- NPI assigned
- Jun 23, 2010
- 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 | 6199 | OK | Primary |
Addresses
Primary practice location
7104 S Sheridan Rd
Suite #8
Tulsa, OK 74133-2770
Mailing address
7104 South Sheridan
Suite #8
Tulsa, OK 74133-2765
Phone (918) 492-1917
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150505002413 | OK | Order and Referring Only - Dentist | 0244559755 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6199 | OK | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1277251200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1277251200000",
"number": "1225349400",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7104 SOUTH SHERIDAN",
"address_2": "SUITE #8",
"city": "TULSA",
"state": "OK",
"postal_code": "741332765",
"telephone_number": "918-492-1917",
"fax_number": "918-492-4538"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7104 S SHERIDAN RD",
"address_2": "SUITE #8",
"city": "TULSA",
"state": "OK",
"postal_code": "741332770",
"telephone_number": "918-492-1917",
"fax_number": "918-492-4538"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAXWELL",
"first_name": "LESLEY",
"middle_name": "ANN",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-06-23",
"last_updated": "2010-06-23",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "OK",
"license": "6199",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tulsa, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2010; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.