Organization Active NPI

Larry D. Lander D.D.S.,M.S. Inc

  • Oral and Maxillofacial Surgery (Dentist)
  • Tulsa, OK
National Provider Identifier
1619291762
Registry record updated Mar 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
3818 Issued in OK
Legal business name
LARRY D. LANDER D.D.S.,M.S. INC
Practice address
6132 E 61St St
Tulsa, OK 74136-2117
Phone
(918) 494-8634
Fax
(918) 494-8636
NPI assigned
Mar 18, 2010
Last updated
Mar 18, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2010

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

Authorized official

Name
Julia E Sams
Title
Contract Coordinator
Phone
(918) 494-8634

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 3818 OK Primary

Addresses

Primary practice location

6132 E 61St St
Tulsa, OK 74136-2117

Mailing address

6132 E 61St St
Tulsa, OK 74136-2117
Phone (918) 494-8634

Other identifiers 1

IdentifierTypeStateIssuer
100174460AMedicaidOK

National Provider Directory

National Provider Directory

Locations

2950 S Elm Pl
Ste 340
Broken Arrow, OK 74012
Phone (918) 451-0944

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1268870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268870400000",
    "number": "1619291762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6132 E 61ST ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741362117",
            "telephone_number": "918-494-8634",
            "fax_number": "918-494-8636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6132 E 61ST ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741362117",
            "telephone_number": "918-494-8634",
            "fax_number": "918-494-8636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LARRY D. LANDER D.D.S.,M.S. INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-18",
        "last_updated": "2010-03-18",
        "status": "A",
        "authorized_official_last_name": "SAMS",
        "authorized_official_first_name": "JULIA",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CONTRACT COORDINATOR",
        "authorized_official_telephone_number": "918-494-8634"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "OK",
            "license": "3818",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100174460A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 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.