Active NPI
Matthew Richard Agee, DDS
- General Practice Dentistry
- Yukon, OK
National Provider Identifier
1750020780
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 7558
- Practice address
- 701 Shedeck Pkwy
Yukon, OK 73099-6021 - Phone
- (405) 494-4055
- NPI assigned
- May 27, 2022
- Last updated
- May 27, 2022
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 7558 | OK | Primary |
Addresses
Primary practice location
701 Shedeck Pkwy
Yukon, OK 73099-6021
Mailing address
4716 Doe Run Dr
Yukon, OK 73099-2344
Phone (405) 397-9703
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 |
|---|---|---|---|
| 7558 | OK | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1653609600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1653609600000",
"number": "1750020780",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4716 DOE RUN DR",
"city": "YUKON",
"state": "OK",
"postal_code": "730992344",
"telephone_number": "405-397-9703"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "701 SHEDECK PKWY",
"city": "YUKON",
"state": "OK",
"postal_code": "730996021",
"telephone_number": "405-494-4055"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AGEE",
"first_name": "MATTHEW",
"middle_name": "RICHARD",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-05-27",
"last_updated": "2022-05-27",
"certification_date": "2022-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "OK",
"license": "7558",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Yukon, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.