NPIMap

Organization Active NPI

Casey a Roberts DDS PC

Doing business as Magnolia City Dental

  • General Practice Dentistry
  • Durant, OK
National Provider Identifier
1760664015
Registry record updated Feb 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5808 Issued in OK
Legal business name
CASEY A ROBERTS DDS PC
Doing business as
Magnolia City Dental
Practice address
2425 W. University Blvd.
Ste. 102
Durant, OK 74701
Phone
(580) 924-3330
Fax
(580) 924-3339
NPI assigned
Nov 28, 2007
Last updated
Feb 24, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2017

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

Authorized official

Name
Dr. Casey A Roberts, D.D.S.NPI 1427278738
Title
Owner/Dentist
Phone
(580) 924-3330

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 5808 OK Primary

Addresses

Primary practice location

2425 W. University Blvd.
Ste. 102
Durant, OK 74701

Mailing address

2425 W. University Blvd.
Ste. 102
Durant, OK 74701
Phone (580) 924-3330

Other names 1

  • Magnolia City Dental Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1196208000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487894400000",
    "number": "1760664015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2425 W. UNIVERSITY BLVD.",
            "address_2": "STE. 102",
            "city": "DURANT",
            "state": "OK",
            "postal_code": "74701",
            "telephone_number": "580-924-3330",
            "fax_number": "580-924-3339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2425 W. UNIVERSITY BLVD.",
            "address_2": "STE. 102",
            "city": "DURANT",
            "state": "OK",
            "postal_code": "74701",
            "telephone_number": "580-924-3330",
            "fax_number": "580-924-3339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CASEY A ROBERTS DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-28",
        "last_updated": "2017-02-24",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "CASEY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "580-924-3330",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "OK",
            "license": "5808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Magnolia City Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Durant, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2017; 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.