Jerry D McCan DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4124 Issued in OK

Legal business name

JERRY D MCCAN DDS

Practice address

7 Cedar Springs Drive
Tuttle, OK 73089-7929

Phone

(405) 381-2303

Fax

(405) 381-2304

NPI assigned

Jun 2, 2008

Last updated

Jun 2, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jerry D McCan, DDSNPI 1003843103

Title

Owner

Phone

(405) 381-2303

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jerry D McCan X, DDS

  • General Practice Dentistry
  • Tuttle, OK
  • NPI 1003843103
  NPD (past) Authorized official

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

{
    "created_epoch": "1212364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212364800000",
    "number": "1265691695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 CEDAR SPRINGS DRIVE",
            "city": "TUTTLE",
            "state": "OK",
            "postal_code": "730897929",
            "telephone_number": "405-381-2303",
            "fax_number": "405-381-2304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 CEDAR SPRINGS DRIVE",
            "city": "TUTTLE",
            "state": "OK",
            "postal_code": "730897929",
            "telephone_number": "405-381-2303",
            "fax_number": "405-381-2304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JERRY D MCCAN DDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-02",
        "last_updated": "2008-06-02",
        "status": "A",
        "authorized_official_last_name": "MCCAN",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "405-381-2303",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OK",
            "license": "4124",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100106100B",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Tuttle, OK
• Providers in Tuttle, OK by specialty
• General Practice Dentistry in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2008; 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.