Active NPI
Paula Elaine Vanbuskirk, DDS
- Pediatric Dentistry
- Ada, OK
National Provider Identifier
1689701518
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 5245
- Practice address
- 1212 Arlington St
Ada, OK 74820-4045 - Phone
- (580) 332-6767
- Fax
- (580) 421-9739
- NPI assigned
- Feb 27, 2007
- Last updated
- May 18, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 5245 | OK | Primary |
Addresses
Primary practice location
1212 Arlington St
Ada, OK 74820-4045
Mailing address
1212 Arlington St
Ada, OK 74820-4045
Phone (580) 332-6767
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200020250A | Medicaid | OK | |
| 20-0692426 | Other | OK | FED TAX ID |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150529000390 | TX | Order and Referring Only - Other (Physician) | 0749500999 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5245 | OK | MD | Pediatric Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Chickasaw Nation Division of Health | Past | Accepting new patients | |
| Chickasaw Nation Division of Health Chickasaw Nation Medical Center | Past | Accepting new patients | |
| All Smiles Dental of Ada PC | Past | Accepting new patients |
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- General Practice Dentistry
- Ada, OK
- NPI 1457978546
-
dba Chickasaw Nation Medical Center
- General Acute Care Hospital
- Ada, OK
- NPI 1255364923
-
dba Chickasaw Nation DME
- Durable Medical Equipment & Medical Supplies
- Ada, OK
- NPI 1295399095
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172534400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1431907200000",
"number": "1689701518",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1212 ARLINGTON ST",
"city": "ADA",
"state": "OK",
"postal_code": "748204045",
"telephone_number": "580-332-6767",
"fax_number": "580-421-9739"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1212 ARLINGTON ST",
"city": "ADA",
"state": "OK",
"postal_code": "748204045",
"telephone_number": "580-332-6767",
"fax_number": "580-421-9739"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANBUSKIRK",
"first_name": "PAULA",
"middle_name": "ELAINE",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-27",
"last_updated": "2015-05-18",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "OK",
"license": "5245",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200020250A",
"state": "OK"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FED TAX ID",
"identifier": "20-0692426",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ada, OK
- Valley View Hospital (Valley View Regional Hospital)
- Valley View Management Group Inc
- Valley View Regional Hospital
- Valley View Regional Hospital
- Valley View Regional Hospital Pharmacy
- Lisa Vantriest-Peaden, LCSW
- George A Vascellaro, DO
- Anna Brooke Vass, PA-C
- Jarred Vaughan
- Melissa Gayle Vavricka-Conaway
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.