W Jack Mann DDS Inc

Primary specialty

DentistTaxonomy code 122300000X

License

3728 Issued in OK

Legal business name

W JACK MANN DDS INC

Practice address

18 Dunlop
Shawnee, OK 74804-3203

Phone

(405) 275-7520

Fax

(405) 275-4787

NPI assigned

Sep 22, 2006

Organization subpart

No

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

Authorized official

Name

Dr. William Jack Mann, DDS

Title

Owner

Phone

(405) 275-7520

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1750480737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 DUNLOP",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "748043203",
            "telephone_number": "405-275-7520",
            "fax_number": "405-275-4787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 DUNLOP",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "748043203",
            "telephone_number": "405-275-7520",
            "fax_number": "405-275-4787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "W JACK MANN DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MANN",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "JACK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "405-275-7520",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "OK",
            "license": "3728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.