Callie D Bouziden, D.D.S

Primary specialty

DentistTaxonomy code 122300000X

License

6183 Issued in OK

Practice address

6565 S Yale Ave
Suite 1100
Tulsa, OK 74136-8327

Phone

(918) 481-4900

NPI assigned

Jun 20, 2010

Last updated

Jun 20, 2010By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mustang Family Dental

  • General Practice Dentistry
  • Mustang, OK
  • NPI 1902276025
  NPD Authorized official

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

{
    "created_epoch": "1276992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276992000000",
    "number": "1649591033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2144 S HUDSON PL",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741142252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6565 S YALE AVE",
            "address_2": "SUITE 1100",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741368327",
            "telephone_number": "918-481-4900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUZIDEN",
        "first_name": "CALLIE",
        "middle_name": "D",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-20",
        "last_updated": "2010-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OK",
            "license": "6183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Harrison Bouma
• James Edward Bourdeau, MD
• Teri Leann Bourdeau, PH.D.
• Thomas Bourland
• Tami Jean Dixie Boutwell
• George Joseph Bovasso Jr., D.O.
• Charisse Bowen-Colley
• Dee Ann Bowen, AA
• Sierra Bowen
• William J Bowen

• Dentist in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Dentist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2010; 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.

Verify at the official NPI Registry.