Custom Dental of Owasso, PLLC

Primary specialty

DentistTaxonomy code 122300000X

License

6099 Issued in OK

Legal business name

CUSTOM DENTAL OF OWASSO, PLLC

Practice address

11501 N. 135TH East Ave
Owasso, OK 74055

Phone

(918) 371-7645

Fax

(918) 371-7272

NPI assigned

Sep 17, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Ron Campbell, DDS

Title

Dentist

Phone

(918) 371-7645

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1284681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284681600000",
    "number": "1659689248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 S DIVISION ST",
            "city": "GUTHRIE",
            "state": "OK",
            "postal_code": "730446063",
            "telephone_number": "405-282-6440",
            "fax_number": "405-282-6785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11501 N. 135TH EAST AVE",
            "city": "OWASSO",
            "state": "OK",
            "postal_code": "74055",
            "telephone_number": "918-371-7645",
            "fax_number": "918-371-7272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUSTOM DENTAL OF OWASSO, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-17",
        "last_updated": "2010-09-17",
        "status": "A",
        "authorized_official_last_name": "CAMPBELL",
        "authorized_official_first_name": "RON",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "918-371-7645",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "OK",
            "license": "6099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Rosella Crowson, MOT
• Donna Culver, DPH
• Ashley M Cummisky
• Bonnie Curry, LMT
• Mark Alan Curtis, DDS
• Daniel & Max LLC
• Sidney Daniel
• Darla Bell DPT PLLC
• Jill N Daugherty
• David L & Stanley J Smith PTRS

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 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.