Active NPI
Brittany Macleod, DDS
- Dentist
- Broken Arrow, OK
National Provider Identifier
1609214550
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 6499
- Practice address
- 901 W Kenosha St
Broken Arrow, OK 74012-8918 - Phone
- (918) 258-8658
- NPI assigned
- Jun 12, 2013
- Sex
- Female
- 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 | 6499 | OK | Primary |
Addresses
Primary practice location
901 W Kenosha St
Broken Arrow, OK 74012-8918
Mailing address
3902S 113TH West Ave
Sand Springs, OK 74063-2724
Phone (918) 245-5800
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OK
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151201001117 | OK | Order and Referring Only - Dentist | 5698075406 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6499 | OK | MD | Orthopaedic Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kenosha Breeze Family Dental PLLC | Dentist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Dentist
- Broken Arrow, OK
- NPI 1346724044
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1370995200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1448236800000",
"number": "1609214550",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3902S 113TH WEST AVE",
"city": "SAND SPRINGS",
"state": "OK",
"postal_code": "740632724",
"telephone_number": "918-245-5800",
"fax_number": "918-245-5803"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "901 W KENOSHA ST",
"city": "BROKEN ARROW",
"state": "OK",
"postal_code": "740128918",
"telephone_number": "918-258-8658"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACLEOD",
"first_name": "BRITTANY",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-06-12",
"last_updated": "2015-11-23",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "OK",
"license": "6499",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Broken Arrow, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.