NPIMap

Organization Active NPI

Cornerstone Dental PLLC

  • Dentist
  • Shawnee, OK
National Provider Identifier
1467612937
Registry record updated Jun 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
4264 Issued in OK
Legal business name
CORNERSTONE DENTAL PLLC
Practice address
1601 Airport Dr
Shawnee, OK 74804-4302
Phone
(405) 273-1020
NPI assigned
Jun 9, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2008

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

Authorized official

Name
Dr. Mickey Lynn Sehorn, D.D.S.NPI 1356383046
Title
President
Phone
(405) 273-1020

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
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 4264 OK Primary

Addresses

Primary practice location

1601 Airport Dr
Shawnee, OK 74804-4302

Mailing address

1601 Airport Dr
Shawnee, OK 74804-4302
Phone (405) 273-1020

National Provider Directory

National Provider Directory

Locations

1601 Airport Dr
Shawnee, OK 74804
Phone (405) 273-1020

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1212969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212969600000",
    "number": "1467612937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 AIRPORT DR",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "748044302",
            "telephone_number": "405-273-1020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 AIRPORT DR",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "748044302",
            "telephone_number": "405-273-1020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORNERSTONE DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-09",
        "last_updated": "2008-06-09",
        "status": "A",
        "authorized_official_last_name": "SEHORN",
        "authorized_official_first_name": "MICKEY",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "405-273-1020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "OK",
            "license": "4264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shawnee, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 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.