NPIMap

Organization Active NPI

Rusty W. Sullins D.D.S., P.C.

  • General Practice Dentistry
  • Oklahoma City, OK
National Provider Identifier
1659545671
Registry record updated Apr 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5243 Issued in OK
Legal business name
RUSTY W. SULLINS D.D.S., P.C.
Practice address
4208 Coletta Dr
Oklahoma City, OK 73120-8317
Phone
(405) 751-9222
NPI assigned
Apr 22, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2008

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

Authorized official

Name
Dr. Rusty Wade Sullins, D.D.S.NPI 1841306057
Title
Owner/Pres.
Phone
(405) 751-9222

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 5243 OK Primary

Addresses

Primary practice location

4208 Coletta Dr
Oklahoma City, OK 73120-8317

Mailing address

4208 Coletta Dr
Oklahoma City, OK 73120-8317
Phone (405) 751-9222

National Provider Directory

National Provider Directory

Locations

4208 Coletta Dr
Oklahoma City, OK 73120
Phone (405) 751-9222

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1208822400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208822400000",
    "number": "1659545671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4208 COLETTA DR",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731208317",
            "telephone_number": "405-751-9222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4208 COLETTA DR",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731208317",
            "telephone_number": "405-751-9222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUSTY W. SULLINS D.D.S., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-22",
        "last_updated": "2008-04-22",
        "status": "A",
        "authorized_official_last_name": "SULLINS",
        "authorized_official_first_name": "RUSTY",
        "authorized_official_middle_name": "WADE",
        "authorized_official_title_or_position": "OWNER/PRES.",
        "authorized_official_telephone_number": "405-751-9222",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "OK",
            "license": "5243",
            "primary": true
        }
    ],
    "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 Apr 22, 2008; 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.