Organization Active NPI

Douglas D Durst DDS PC

  • General Practice Dentistry
  • Piedmont, OK
National Provider Identifier
1508080235
Registry record updated Apr 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
DOUGLAS D DURST DDS PC
Practice address
51 Gooder Simpson Blvd NE
Suite a
Piedmont, OK 73978-9237
Phone
(405) 373-2119
Fax
(405) 373-0809
NPI assigned
Apr 12, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2024

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

Authorized official

Name
Dr. Douglas D Durst, DDSNPI 1689779167
Title
Dentist
Phone
(405) 373-2119

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary
Customized Equipment (DME) 332BC3200X

Addresses

Primary practice location

51 Gooder Simpson Blvd NE
Suite a
Piedmont, OK 73978-9237

Mailing address

51 Gooder Simpson Blvd NE
Suite a
Piedmont, OK 73078-9237
Phone (405) 373-2119

Other identifiers 1

IdentifierTypeStateIssuer
200092500AMedicaidOK

National Provider Directory

National Provider Directory

Locations

51 Gooder Simpson Blvd
Ste A
Piedmont, OK 73078
Phone (405) 373-2119

Practitioners & affiliated clinicians

Practitioners 1

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": "1176336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712707200000",
    "number": "1508080235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 GOODER SIMPSON BLVD NE",
            "address_2": "SUITE A",
            "city": "PIEDMONT",
            "state": "OK",
            "postal_code": "730789237",
            "telephone_number": "405-373-2119",
            "fax_number": "405-373-0809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 GOODER SIMPSON BLVD NE",
            "address_2": "SUITE A",
            "city": "PIEDMONT",
            "state": "OK",
            "postal_code": "739789237",
            "telephone_number": "405-373-2119",
            "fax_number": "405-373-0809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOUGLAS D DURST DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-12",
        "last_updated": "2024-04-10",
        "certification_date": "2024-04-10",
        "status": "A",
        "authorized_official_last_name": "DURST",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "405-373-2119",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200092500A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Piedmont, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2024; 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.