Individual provider Active NPI

Emerald Brooke Ferguson, DDS

  • General Practice Dentistry
  • Oklahoma City, OK
National Provider Identifier
1760172316
Registry record updated Mar 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7742 Issued in OK
Practice address
1025 Straka Ter
Oklahoma City, OK 73139-2544
Phone
(405) 632-6688
NPI assigned
May 8, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2024

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 7742 OK Primary

Addresses

Primary practice location

1025 Straka Ter
Oklahoma City, OK 73139-2544

Mailing address

3000 N Grand Blvd
Oklahoma City, OK 73107-1818
Phone (056) 326-6884

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
I20230608002235 OK Practitioner - Dentist 4284091109 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7742OKMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Variety Care, Inc. CurrentSince Jul 10, 2023 Accepting new patients
Variety Care, Inc. CurrentSince Jul 10, 2023 Accepting new patients

Locations

3000 N Grand Blvd
Oklahoma City, OK 73107
Phone 405632668810209

1025 Straka Ter
Oklahoma City, OK 73139
Phone (405) 629-5281

Interoperability endpoints

  • Direct secure messaging: eferguson648220@direct.ochin.org

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1683504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711670400000",
    "number": "1760172316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 N GRAND BLVD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731071818",
            "telephone_number": "056-326-6884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 STRAKA TER",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731392544",
            "telephone_number": "405-632-6688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERGUSON",
        "first_name": "EMERALD",
        "middle_name": "BROOKE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-08",
        "last_updated": "2024-03-29",
        "certification_date": "2024-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OK",
            "license": "7742",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.