Jake Boone
Individual provider Active NPI Orthodontics and Dentofacial Orthopedics Dentistry · Bethany, OK
NPI 1649914938 · NPPES record last updated Feb 19, 2026
Key facts
- NPI
- 1649914938
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X
- License
- 7560 (OK)
- Practice address
- 7221 NW 23Rd St Unit C-D
Bethany, OK 73008-5131 - Phone
- (405) 367-8147
- NPI assigned
- Apr 23, 2022
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Dentist
- Education
- University of Nevada, Las Vegas School of Medicine, 2025
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1459 N US Hwy 1
Suite 2a
Ormond Beach, FL 32174-0707
1459 N US Hwy 1 2a
Ormond Beach, FL 32174-0707
527 W 3Rd St
Konawa, OK 74849-1415
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OK
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260116003563 | OK | Practitioner - Dentist | 9537646872 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Central Oklahoma Family Medical Center Inc | Current |
Accepting new patients | |
| Central Oklahoma Family Medical Center, Inc | Current |
Accepting new patients |
Locations
1221 Arlington St
Ste B
Ada, OK 74820
Phone (580) 332-4700
807 N Monte Vista St
Ada, OK 74820
Phone (580) 279-6413
304 N Monte Vista St
Ada, OK 74820
Phone (405) 584-4078
527 W 3rd St
Konawa, OK 74849
Phone (580) 925-3286
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 7560 | OK | Yes |
Addresses
Primary practice location
7221 NW 23Rd St Unit C-D
Bethany, OK 73008-5131
Mailing address
301 W Kings Rd
Ada, OK 74820-8219
Other practice location 1
304 N Monte Vista St
Ada, OK 74820-4607
Phone (580) 436-5111
Other providers in Bethany, OK
- Bethany United Drug Co
- Tanya Billingsley
- Rachel Blevins
- Meredith Storm Bolt
- Karlee Michaela Bond
- Tara Booth
- Chalmer Hadley Bowman
- Hope Katelyn Boyer
- Darin Kent Brannan
- Kristen Rene' Brannan
All providers in Bethany, OK · Orthodontics and Dentofacial Orthopedics Dentistry in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 19, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.