Individual provider Active NPI

Kimberly D Greenlee, DDS

  • General Practice Dentistry
  • Midwest City, OK
National Provider Identifier
1669522009
Registry record updated Nov 21, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5873 Issued in OK
Practice address
My Dentist 1900 S. Air Depot
Suite 1
Midwest City, OK 73110-5522
Phone
(405) 455-1534
Fax
(405) 455-1513
NPI assigned
Jan 10, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 5873 OK Primary

Addresses

Primary practice location

My Dentist 1900 S. Air Depot
Suite 1
Midwest City, OK 73110-5522

Mailing address

My Dentist 1900 S. Air Depot
Suite 1
Midwest City, OK 73110-5522
Phone (405) 455-1534

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Summer Dental Midwest City, PLLC General Practice PastSince Aug 16, 2020 Accepting new patients
Okc Dental Health Associates, P.C. General Practice Past Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195603200000",
    "number": "1669522009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MY DENTIST 1900 S. AIR DEPOT",
            "address_2": "SUITE 1",
            "city": "MIDWEST CITY",
            "state": "OK",
            "postal_code": "731105522",
            "telephone_number": "405-455-1534",
            "fax_number": "405-455-1513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MY DENTIST 1900 S. AIR DEPOT",
            "address_2": "SUITE 1",
            "city": "MIDWEST CITY",
            "state": "OK",
            "postal_code": "731105522",
            "telephone_number": "405-455-1534",
            "fax_number": "405-455-1513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENLEE",
        "first_name": "KIMBERLY",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-10",
        "last_updated": "2007-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OK",
            "license": "5873",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midwest City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2007; 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.