NPIMap

Organization Active NPI

Liberty Dental, Inc.

  • General Practice Dentistry
  • Carnegie, OK
National Provider Identifier
1497072094
Registry record updated Apr 23, 2010
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Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5940 Issued in OK
Legal business name
LIBERTY DENTAL, INC.
Practice address
6 N. Broadway
Carnegie, OK 73015
Phone
(580) 654-1008
Fax
(580) 654-2008
NPI assigned
Apr 23, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2010

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

Authorized official

Name
Jamie Lynne Cameron, D.D.S.
Title
Owner/Dentist
Phone
(580) 654-1008

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 5940 OK Primary

Addresses

Primary practice location

6 N. Broadway
Carnegie, OK 73015

Mailing address

P.O. Box 365
Carnegie, OK 73015
Phone (580) 654-1008

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1271980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271980800000",
    "number": "1497072094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 365",
            "city": "CARNEGIE",
            "state": "OK",
            "postal_code": "73015",
            "telephone_number": "580-654-1008",
            "fax_number": "580-654-2008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 N. BROADWAY",
            "city": "CARNEGIE",
            "state": "OK",
            "postal_code": "73015",
            "telephone_number": "580-654-1008",
            "fax_number": "580-654-2008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY DENTAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-23",
        "last_updated": "2010-04-23",
        "status": "A",
        "authorized_official_last_name": "CAMERON",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_middle_name": "LYNNE",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "580-654-1008",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "OK",
            "license": "5940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carnegie, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2010; 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.