MBC Dental

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

MBC DENTAL

Practice address

401 S. Utica Ave
#A
Tulsa, OK 74104

Phone

(918) 895-6568

NPI assigned

Mar 15, 2016

Organization subpart

No

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

Authorized official

Name

Renee McBay

Title

Credentialing Specialist

Phone

(918) 998-0996

Specialties & licenses 1

Addresses

Other names 1

• Smiles 4 Life Doing business as

Locations

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

{
    "created_epoch": "1458000000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1528934400000",
    "number": "1669833851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 RIVERWALK TERRACE",
            "address_2": "STE 250",
            "city": "JENKS",
            "state": "OK",
            "postal_code": "740375619",
            "telephone_number": "918-998-0996",
            "fax_number": "918-235-9079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 S. UTICA AVE",
            "address_2": "#A",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "74104",
            "telephone_number": "918-895-6568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MBC DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-15",
        "last_updated": "2018-06-14",
        "status": "A",
        "authorized_official_last_name": "MCBAY",
        "authorized_official_first_name": "RENEE",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "918-998-0996"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Smiles 4 Life",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Antuanette Marjorie Maysundo
• Anna Mazur, PHD
• Christa Ann Mazza, M.ED
• Noel Mazzei
• Astou Star Mbacke, BHRS
• Claris Mbeleka, CRNA
• Dow Greg MC Carty, PH.D.
• McAdams Mental Health Counseling LLC
• David Palmer McAdams, D.O.
• Jimmie D McAdams Jr., DO

• General Practice Dentistry in Tulsa, OK
• Providers in Tulsa, OK by specialty
• General Practice Dentistry in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2018; 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.