Madison Campbell, DDS
Individual provider Active NPI Dentist · Alva, OK
NPI 1306567607 · NPPES record last updated Sep 6, 2022
Key facts
- NPI
- 1306567607
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 7564 (OK)
- Practice address
- 605 Barnes Ave
Alva, OK 73717-2231 - Phone
- (580) 327-4522
- NPI assigned
- Sep 6, 2022
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7564 | OK | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Larry G. Smith, D.D.S., Inc. | Single Specialty | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist |
122300000X | 7564 | OK | Yes |
Addresses
Primary practice location
605 Barnes Ave
Alva, OK 73717-2231
Mailing address
605 Barnes Ave
Alva, OK 73717-2231
Phone (580) 327-4522
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | hometowndentalalva@gmail.com | Direct |
Other providers in Alva, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 6, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.