Active NPI
Michael Ahlborn, DDS
- Dentist
- Sulphur, OK
National Provider Identifier
1477044410
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 7028
- Practice address
- 1808 W Broadway Ave
Sulphur, OK 73086-4246 - Phone
- (801) 636-8716
- NPI assigned
- May 25, 2018
- Last updated
- Apr 19, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 7028 | OK | Primary |
Addresses
Primary practice location
1808 W Broadway Ave
Sulphur, OK 73086-4246
Mailing address
4802 Lake Shore Dr
Ardmore, OK 73401-6440
Phone (580) 622-6655
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gulf Shores Dental PLLC | Current | Accepting new patients | |
| Sulphur Dentistry & Braces | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Dental Clinic/Center
- Gulf Shores, AL
- NPI 1134859648
-
- Dental Clinic/Center
- Sulphur, OK
- NPI 1730679606
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1527206400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1555632000000",
"number": "1477044410",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4802 LAKE SHORE DR",
"city": "ARDMORE",
"state": "OK",
"postal_code": "734016440",
"telephone_number": "580-622-6655"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1808 W BROADWAY AVE",
"city": "SULPHUR",
"state": "OK",
"postal_code": "730864246",
"telephone_number": "801-636-8716"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AHLBORN",
"first_name": "MICHAEL",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-05-25",
"last_updated": "2019-04-19",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "OK",
"license": "7028",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sulphur, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.