Casey a Roberts DDS PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5808 Issued in OK

Legal business name

CASEY A ROBERTS DDS PC

Practice address

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

Phone

(580) 924-3330

Fax

(580) 924-3339

NPI assigned

Nov 28, 2007

Organization subpart

No

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.

Title

Owner/Dentist

Phone

(580) 924-3330

Specialties & licenses 1

Addresses

Other names 1

• Magnolia City Dental Doing business as

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"
        }
    ]
}

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• General Practice Dentistry in Durant, OK
• Providers in Durant, OK by specialty
• General Practice Dentistry in Oklahoma

• 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.