NPIMap

Organization Active NPI

Blue and Red Dental LLC

Doing business as Shine Dental

  • Preferred Provider Organization
  • Tulsa, OK
National Provider Identifier
1427322361
Registry record updated Feb 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Preferred Provider OrganizationTaxonomy code 305R00000X
License
5990 Issued in OK
Legal business name
BLUE AND RED DENTAL LLC
Doing business as
Shine Dental
Practice address
2840 E 101St St
Tulsa, OK 74137-5601
Phone
(918) 518-6305
Fax
(918) 518-6327
NPI assigned
Feb 23, 2012
Last updated
Feb 23, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2012

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

Authorized official

Name
Dr. Brian Dale Patten, D.D.S.NPI 1497946909
Title
Dentist
Phone
(918) 518-6305

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Preferred Provider Organization 305R00000X 5990 OK Primary

Addresses

Primary practice location

2840 E 101St St
Tulsa, OK 74137-5601

Mailing address

2840 E 101St St
Tulsa, OK 74137-5601
Phone (918) 518-6305

Other identifiers 1

IdentifierTypeStateIssuer
200119910AMedicaidOK

Other names 1

  • Shine Dental Doing business as

National Provider Directory

National Provider Directory

Locations

2840 E 101st St
Tulsa, OK 74137
Phone (918) 518-6305

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1329955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329955200000",
    "number": "1427322361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2840 E 101ST ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741375601",
            "telephone_number": "918-518-6305",
            "fax_number": "918-518-6327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2840 E 101ST ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741375601",
            "telephone_number": "918-518-6305",
            "fax_number": "918-518-6327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE AND RED DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-23",
        "last_updated": "2012-02-23",
        "status": "A",
        "authorized_official_last_name": "PATTEN",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "DALE",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "918-518-6305",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "OK",
            "license": "5990",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200119910A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shine Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tulsa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2012; 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.