Individual provider Active NPI

Tommy Lee McCreight, DDS

  • General Practice Dentistry
  • Sallisaw, OK
National Provider Identifier
1730105511
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
OK3024 Issued in OK
Practice address
502 W Cherokee Ave
Sallisaw, OK 74955-4212
Phone
(918) 775-3742
NPI assigned
Jul 14, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X OK3024 OK Primary

Addresses

Primary practice location

502 W Cherokee Ave
Sallisaw, OK 74955-4212

Mailing address

502 W Cherokee Ave
Sallisaw, OK 74955-4212
Phone (918) 775-3742

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160620001055 OK Order and Referring Only - DentistPractitioner - Dentist 9638460868

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3024OKMDClinical Social Worker
OK3024OKMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1730105511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "502 W CHEROKEE AVE",
            "city": "SALLISAW",
            "state": "OK",
            "postal_code": "749554212",
            "telephone_number": "918-775-3742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 W CHEROKEE AVE",
            "city": "SALLISAW",
            "state": "OK",
            "postal_code": "749554212",
            "telephone_number": "918-775-3742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCREIGHT",
        "first_name": "TOMMY",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OK",
            "license": "OK3024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sallisaw, OK

Sources for this page

Verify at the official NPI Registry.