Organization Active NPI

Smile Doctors of Oklahoma PC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Tulsa, OK
National Provider Identifier
1659960649
Registry record updated Jan 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
Legal business name
SMILE DOCTORS OF OKLAHOMA PC
Practice address
4550 S Harvard Ave
Tulsa, OK 74135-2906
Phone
(918) 749-8817
NPI assigned
Jan 13, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2021

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

Authorized official

Name
Gregory Goggans
Title
President
Phone
(918) 749-8817

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223X0400X Primary

Addresses

Primary practice location

4550 S Harvard Ave
Tulsa, OK 74135-2906

Mailing address

PO Box 674459
Dallas, TX 75267-4459

Other practice location 1

333 W Blue Starr Dr
Claremore, OK 74017-5808
Phone (918) 342-1240

Other practice location 2

519 E 141st St
Glenpool, OK 74033-3588
Phone (918) 369-6100

Other practice location 3

11910 S Memorial Dr
Bixby, OK 74008-2170
Phone (918) 369-6100

National Provider Directory

National Provider Directory

Locations

11910 S Memorial Dr
Bixby, OK 74008
Phone (918) 369-6100

333 W Blue Starr Dr
Claremore, OK 74017
Phone (918) 342-1240

519 E 141st St
Glenpool, OK 74033
Phone (918) 219-1222

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": "1610496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610496000000",
    "number": "1659960649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 674459",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752674459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4550 S HARVARD AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741352906",
            "telephone_number": "918-749-8817"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "333 W Blue Starr Dr",
            "address_purpose": "LOCATION",
            "city": "Claremore",
            "state": "OK",
            "postal_code": "740175808",
            "country_code": "US",
            "telephone_number": "918-342-1240",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "519 E 141st St",
            "address_purpose": "LOCATION",
            "city": "Glenpool",
            "state": "OK",
            "postal_code": "740333588",
            "country_code": "US",
            "telephone_number": "918-369-6100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11910 S Memorial Dr",
            "address_purpose": "LOCATION",
            "city": "Bixby",
            "state": "OK",
            "postal_code": "740082170",
            "country_code": "US",
            "telephone_number": "918-369-6100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SMILE DOCTORS OF OKLAHOMA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-13",
        "last_updated": "2021-01-13",
        "certification_date": "2021-01-13",
        "status": "A",
        "authorized_official_last_name": "GOGGANS",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "918-749-8817"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jan 13, 2021; 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.