Organization Active NPI

John Rogers DDS PC

  • General Practice Dentistry
  • Tulsa, OK
National Provider Identifier
1700135407
Registry record updated Sep 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6209 Issued in OK
Legal business name
JOHN ROGERS DDS PC
Practice address
6802 S Olympia Ave
Suite 275
Tulsa, OK 74132-1823
Phone
(918) 408-9543
NPI assigned
Sep 10, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2012

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

Authorized official

Name
Dr. John M Rogers, D.D.S.
Title
Owner
Phone
(918) 408-9543

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 6209 OK Primary

Addresses

Primary practice location

6802 S Olympia Ave
Suite 275
Tulsa, OK 74132-1823

Mailing address

6802 S Olympia Ave
Suite 275
Tulsa, OK 74132-1823
Phone (918) 408-9543

Other identifiers 1

IdentifierTypeStateIssuer
200297330AMedicaidOK

Other names 1

  • Refresh Doing business as

National Provider Directory

National Provider Directory

Locations

6802 S Olympia Ave
Ste 275
Tulsa, OK 74132
Phone (918) 508-7601

NPI Registry JSON

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

{
    "created_epoch": "1347235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1347235200000",
    "number": "1700135407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6802 S OLYMPIA AVE",
            "address_2": "SUITE 275",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741321823",
            "telephone_number": "918-408-9543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6802 S OLYMPIA AVE",
            "address_2": "SUITE 275",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741321823",
            "telephone_number": "918-408-9543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN ROGERS DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-10",
        "last_updated": "2012-09-10",
        "status": "A",
        "authorized_official_last_name": "ROGERS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "918-408-9543",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "OK",
            "license": "6209",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200297330A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Refresh",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tulsa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2012; 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.