Active NPI
Terry Lynn Dean, M.D.
- General Practice Physician
- Tahlequah, OK
National Provider Identifier
1730165820
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- 17917
- Practice address
- 17675 S Muskogee Ave
Tahlequah, OK 74464-5492 - Phone
- (918) 453-5387
- Fax
- (918) 458-6159
- NPI assigned
- Dec 20, 2005
- Sex
- Female
- 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 |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 17917 | OK | Primary |
| General Practice Physician | 208D00000X | R2G69 | MO |
Addresses
Primary practice location
17675 S Muskogee Ave
Tahlequah, OK 74464-5492
Mailing address
1400 N Juniper PL
Broken Arrow, OK 74012-1540
Phone (918) 258-6519
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1117917 | Medicaid | OK |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R2G69 | MO | MD | General Practice Physician |
| 17917 | OK | MD | General Practice Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cherokee Nation | Past | Accepting new patients | |
| Northeastern State University College of Optometry | Past | Accepting new patients | |
| Cherokee Nation | Past | Accepting new patients |
Interoperability endpoints
- https://fhir-myrecord.cerner.com/r4/2d405cde-1d8b-4a50-adff-ca7776cd856e/
Organizations & group practices 3
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.
-
- Public Health or Welfare Agency
- Tahlequah, OK
- NPI 1013884154
-
- Multi-Specialty Clinic/Center
- Tahlequah, OK
- NPI 1093722324
-
- Optometrist
- Tahlequah, OK
- NPI 1437106333
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1135036800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1730165820",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1400 N JUNIPER PL",
"city": "BROKEN ARROW",
"state": "OK",
"postal_code": "740121540",
"telephone_number": "918-258-6519"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17675 S MUSKOGEE AVE",
"city": "TAHLEQUAH",
"state": "OK",
"postal_code": "744645492",
"telephone_number": "918-453-5387",
"fax_number": "918-458-6159"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEAN",
"first_name": "TERRY",
"middle_name": "LYNN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-12-20",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "OK",
"license": "17917",
"primary": true
},
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "MO",
"license": "R2G69",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1117917",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Tahlequah, 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.