Phillip W Powell DDS

Primary specialty

DentistTaxonomy code 122300000X

License

4793 Issued in OK

Legal business name

PHILLIP W POWELL DDS

Practice address

1222 Main Ave
Woodward, OK 73801

Phone

(580) 256-2600

Fax

(580) 256-2671

NPI assigned

Jun 17, 2008

Organization subpart

No

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

Authorized official

Name

Phillip W Powell, DDS

Title

Owner

Phone

(580) 256-2600

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Woodward Family Dentistry Other name

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

{
    "created_epoch": "1213660800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213660800000",
    "number": "1437310067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1222 MAIN AVE",
            "city": "WOODWARD",
            "state": "OK",
            "postal_code": "73801",
            "telephone_number": "580-256-2600",
            "fax_number": "580-256-2671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1222 MAIN AVE",
            "city": "WOODWARD",
            "state": "OK",
            "postal_code": "73801",
            "telephone_number": "580-256-2600",
            "fax_number": "580-256-2671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHILLIP W POWELL DDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-17",
        "last_updated": "2008-06-17",
        "status": "A",
        "authorized_official_last_name": "POWELL",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "580-256-2600",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "OK",
            "license": "4793",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100130660A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Woodward Family Dentistry",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Dentist in Woodward, OK
• Providers in Woodward, OK by specialty
• Dentist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 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.