Active NPI
William G Bozalis, DDS MS PC
- Pediatric Dentistry
- Oklahoma City, OK
National Provider Identifier
1720063225
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 3672
- Practice address
- 3613 NW 56TH
Suite 105 Three Corporate Plaza
Oklahoma City, OK 73112 - Phone
- (405) 946-2455
- Fax
- (405) 946-3445
- NPI assigned
- Dec 7, 2005
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 3672 | OK | Primary |
Addresses
Primary practice location
3613 NW 56TH
Suite 105 Three Corporate Plaza
Oklahoma City, OK 73112
Mailing address
3613 NW 56TH
Suite 105 Three Corporate Plaza
Oklahoma City, OK 73112
Phone (405) 946-2455
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 446465286001 | Other | OK | BLUE CROSS BLUE SHIELD |
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
- Credentials
- Master of Science
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Summit Medical Center | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Acute Care Hospital
- Edmond, OK
- NPI 1356574560
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133913600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1720063225",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3613 NW 56TH",
"address_2": "SUITE 105 THREE CORPORATE PLAZA",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "73112",
"telephone_number": "405-946-2455",
"fax_number": "405-946-3445"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3613 NW 56TH",
"address_2": "SUITE 105 THREE CORPORATE PLAZA",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "73112",
"telephone_number": "405-946-2455",
"fax_number": "405-946-3445"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOZALIS",
"first_name": "WILLIAM",
"middle_name": "G",
"name_prefix": "Mr.",
"credential": "DDS MS PC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-07",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "OK",
"license": "3672",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "446465286001",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Oklahoma City, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 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.