Active NPI
Zachary Dacus, DDS
- Dentist
- Oklahoma City, OK
National Provider Identifier
1619005949
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 6561
- Practice address
- 1201 N Stonewall Ave
Oklahoma City, OK 73117-1214 - Phone
- (405) 271-5444
- NPI assigned
- Feb 28, 2007
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 6561 | OK | Primary |
| General Practice Dentistry | 1223G0001X | 1120 | WY |
Addresses
Primary practice location
1201 N Stonewall Ave
Oklahoma City, OK 73117-1214
Mailing address
4240 Wake Forest Rd
Edmond, OK 73034-9222
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1120 | WY | MD | Counselor |
| 6561 | OK | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172620800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1424563200000",
"number": "1619005949",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4240 WAKE FOREST RD",
"city": "EDMOND",
"state": "OK",
"postal_code": "730349222"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1201 N STONEWALL AVE",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731171214",
"telephone_number": "405-271-5444"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DACUS",
"first_name": "ZACHARY",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-28",
"last_updated": "2015-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "OK",
"license": "6561",
"primary": true
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "WY",
"license": "1120",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oklahoma City, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.