Redbud Dental Midwest City

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

License

1223G0001X Issued in OK

Legal business name

REDBUD DENTAL MIDWEST CITY

Practice address

101 N Douglas Blvd
Ste T
Midwest City, OK 73130-3329

Phone

(405) 888-5379

NPI assigned

May 25, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Adam C Brewer, D.D.S.

Title

Owner/Dentist

Phone

(405) 888-5379

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1432512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432512000000",
    "number": "1225417207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 N DOUGLAS BLVD",
            "address_2": "STE T",
            "city": "MIDWEST CITY",
            "state": "OK",
            "postal_code": "731303329",
            "telephone_number": "405-888-5379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 N DOUGLAS BLVD",
            "address_2": "STE T",
            "city": "MIDWEST CITY",
            "state": "OK",
            "postal_code": "731303329",
            "telephone_number": "405-888-5379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REDBUD DENTAL MIDWEST CITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-25",
        "last_updated": "2015-05-25",
        "status": "A",
        "authorized_official_last_name": "BREWER",
        "authorized_official_first_name": "ADAM",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "405-888-5379",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "OK",
            "license": "1223G0001X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200199260A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Shanon Leigh Reed, D.O.
• Regenerative Medicine Centers of Oklahoma LLC
• Chris W Regier, DO
• Regional Physical Therapy Inc

• Health Maintenance Organization in Midwest City, OK
• Providers in Midwest City, OK by specialty
• Health Maintenance Organization in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2015; 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.