Individual provider Active NPI

Julie Speights, DDS

  • General Practice Dentistry
  • Oklahoma City, OK
National Provider Identifier
1386769388
Registry record updated Dec 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5293 Issued in OK
Practice address
1201 N Stonewall Ave
Oklahoma City, OK 73117-1214
Phone
(405) 271-4160
NPI assigned
Mar 20, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 5293 OK Primary

Addresses

Primary practice location

1201 N Stonewall Ave
Oklahoma City, OK 73117-1214

Mailing address

1201 N Stonewall Ave
Oklahoma City, OK 73117-1214
Phone (405) 271-4160

Other identifiers 1

IdentifierTypeStateIssuer
200054290-AMedicaidOK

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180109002108 OK Order and Referring Only - DentistPractitioner - Dentist 1254690704

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5293OKMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Bright Smile Family Dentistry PLLC General Practice Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575331200000",
    "number": "1386769388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 N STONEWALL AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731171214",
            "telephone_number": "405-271-4160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 N STONEWALL AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731171214",
            "telephone_number": "405-271-4160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPEIGHTS",
        "first_name": "JULIE",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-20",
        "last_updated": "2019-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OK",
            "license": "5293",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200054290-A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.