Active NPI
Heath Mitchell Potter, D.D.S.
- Dentist
- Bartlesville, OK
National Provider Identifier
1710272281
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 6296
- Practice address
- 4200 SE Adams Rd
Ste a
Bartlesville, OK 74006-8448 - Phone
- (918) 333-3694
- NPI assigned
- Jun 13, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 6296 | OK | Primary |
| Dentist | 122300000X | 60838 | KS |
Addresses
Primary practice location
4200 SE Adams Rd
Ste a
Bartlesville, OK 74006-8448
Mailing address
4200 SE Adams Rd
Ste a
Bartlesville, OK 74006-8448
Phone (918) 333-3694
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
| License | State | Type | Specialty |
|---|---|---|---|
| 60838 | KS | MD | Dentist |
| 6296 | OK | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1307923200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1308441600000",
"number": "1710272281",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4200 SE ADAMS RD",
"address_2": "STE A",
"city": "BARTLESVILLE",
"state": "OK",
"postal_code": "740068448",
"telephone_number": "918-333-3694"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4200 SE ADAMS RD",
"address_2": "STE A",
"city": "BARTLESVILLE",
"state": "OK",
"postal_code": "740068448",
"telephone_number": "918-333-3694"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POTTER",
"first_name": "HEATH",
"middle_name": "MITCHELL",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-06-13",
"last_updated": "2011-06-19",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "OK",
"license": "6296",
"primary": true
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "KS",
"license": "60838",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bartlesville, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.