NPIMap

Organization Active NPI

Dental Specialists of Edmond

  • Prosthodontics
  • Edmond, OK
National Provider Identifier
1699395343
Registry record updated Apr 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
Legal business name
DENTAL SPECIALISTS OF EDMOND
Practice address
16430 Muirfield PL
Edmond, OK 73013
Phone
(405) 696-0908
NPI assigned
Apr 23, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2020

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

Authorized official

Name
Dr. Yacoub Al Sakka, DDSNPI 1568862357
Title
Co-Owner
Phone
(405) 696-0908

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
PeriodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0300X
ProsthodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0700X Primary

Addresses

Primary practice location

16430 Muirfield PL
Edmond, OK 73013

Mailing address

17705 Sparrow Hawk LN
Edmond, OK 73012-7137
Phone (405) 510-6853

Other identifiers 2

IdentifierTypeStateIssuer
1568862357OtherOKPROVIDER 01
1497023196OtherOKPROVIDER 02

National Provider Directory

National Provider Directory

Locations

16430 Muirfield Pl
Edmond, OK 73013
Phone (405) 510-6853

Practitioners & affiliated clinicians

Practitioners 3

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": "1587600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587600000000",
    "number": "1699395343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17705 SPARROW HAWK LN",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730127137",
            "telephone_number": "405-510-6853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16430 MUIRFIELD PL",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "73013",
            "telephone_number": "405-696-0908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL SPECIALISTS OF EDMOND",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-23",
        "last_updated": "2020-04-23",
        "certification_date": "2020-04-23",
        "status": "A",
        "authorized_official_last_name": "AL SAKKA",
        "authorized_official_first_name": "YACOUB",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "405-696-0908",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Prosthodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER 01",
            "identifier": "1568862357",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER 02",
            "identifier": "1497023196",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmond, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2020; 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.