Individual provider Active NPI

Joey Steven Seale, D.D.S.

  • Dentist
  • Oklahoma City, OK
National Provider Identifier
1417185901
Registry record updated Jun 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
6114 Issued in OK
Practice address
1144 SW 104TH St
Oklahoma City, OK 73139-2992
Phone
(405) 912-0778
NPI assigned
Jun 23, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 23, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 6114 OK Primary

Addresses

Primary practice location

1144 SW 104TH St
Oklahoma City, OK 73139-2992

Mailing address

11208 N Timberline Dr
Norman, OK 73026-8064
Phone (405) 307-0996

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20161111001841 AL Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 9638458714

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6114OKMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1245715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245715200000",
    "number": "1417185901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11208 N TIMBERLINE DR",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730268064",
            "telephone_number": "405-307-0996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1144 SW 104TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731392992",
            "telephone_number": "405-912-0778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEALE",
        "first_name": "JOEY",
        "middle_name": "STEVEN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-06-23",
        "last_updated": "2009-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OK",
            "license": "6114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.