Organization Active NPI

Richard Drew DDS & J 'Gus' Wilson DDS PC

  • General Practice Dentistry
  • Oklahoma City, OK
National Provider Identifier
1740335827
Registry record updated Aug 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5039 Issued in OK
Legal business name
RICHARD DREW DDS & J 'GUS' WILSON DDS PC
Practice address
1000 SW 44TH St Ste 100
Oklahoma City, OK 73109-3629
Phone
(405) 632-6601
Fax
(405) 632-6031
NPI assigned
Jan 25, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2026

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

Authorized official

Name
Tammy Banta
Title
Office Manager
Phone
(405) 632-6601

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 5039 OK Primary

Addresses

Primary practice location

1000 SW 44TH St Ste 100
Oklahoma City, OK 73109-3629

Mailing address

1000 SW 44TH St Ste 100
Oklahoma City, OK 73109-3629
Phone (405) 632-6601

Other identifiers 1

IdentifierTypeStateIssuer
100131210AMedicaidOK

National Provider Directory

National Provider Directory

Locations

1044 SW 44th St
Ste 510
Oklahoma City, OK 73109
Phone (405) 632-6601

1000 SW 44th St
Ste 100
Oklahoma City, OK 73109
Phone (405) 632-4616

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787184000000",
    "number": "1740335827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 SW 44TH ST STE 100",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731093629",
            "telephone_number": "405-632-6601",
            "fax_number": "405-632-6031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 SW 44TH ST STE 100",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731093629",
            "telephone_number": "405-632-6601",
            "fax_number": "405-632-6031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICHARD DREW DDS & J 'GUS' WILSON DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-25",
        "last_updated": "2026-08-20",
        "certification_date": "2026-08-20",
        "status": "A",
        "authorized_official_last_name": "BANTA",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "405-632-6601"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "OK",
            "license": "5039",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100131210A",
            "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 Aug 20, 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.

Verify at the official NPI Registry.