Individual provider Active NPI

Mayce-Arreem Issa, DMD

  • General Practice Dentistry
  • Broken Arrow, OK
National Provider Identifier
1679346605
Registry record updated May 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
8231 Issued in OK
Practice address
2109 W Washington St
Broken Arrow, OK 74012-6801
Phone
(918) 455-0123
NPI assigned
Nov 1, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 15, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 8231 OK Primary

Addresses

Primary practice location

2109 W Washington St
Broken Arrow, OK 74012-6801

Mailing address

2109 W Washington St
Broken Arrow, OK 74012-6801
Phone (918) 455-0123

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

State licenses

LicenseStateTypeSpecialty
8231OKMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Reggie D. Thomas, DMD, Inc. Past Accepting new patients
Broken Arrow Dental and Implants, LLC PastSince Jan 17, 2022 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": "1698796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778803200000",
    "number": "1679346605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2109 W WASHINGTON ST",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740126801",
            "telephone_number": "918-455-0123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2109 W WASHINGTON ST",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740126801",
            "telephone_number": "918-455-0123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISSA",
        "first_name": "MAYCE-ARREEM",
        "name_prefix": "Miss",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-11-01",
        "last_updated": "2026-05-15",
        "certification_date": "2026-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "OK",
            "license": "8231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Broken Arrow, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2026; 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.