Individual provider Active NPI

Christopher Neal Corbin, DDS

  • Dentist
  • Shawnee, OK
National Provider Identifier
1760703292
Registry record updated Apr 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
6187 Issued in OK
Practice address
2025 S Gordon Cooper Dr
Shawnee, OK 74801-9005
Phone
(405) 275-3200
NPI assigned
Jun 18, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 6187 OK Primary

Addresses

Primary practice location

2025 S Gordon Cooper Dr
Shawnee, OK 74801-9005

Mailing address

2307 Gordon Cooper Dr
Shawnee, OK 74801-9007
Phone (405) 964-4025

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20170504000914 TX Order and Referring Only - DentistPractitioner - Dentist 7517244320

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6187OKMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1276819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493251200000",
    "number": "1760703292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2307 GORDON COOPER DR",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "748019007",
            "telephone_number": "405-964-4025",
            "fax_number": "405-964-4032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2025 S GORDON COOPER DR",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "748019005",
            "telephone_number": "405-275-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORBIN",
        "first_name": "CHRISTOPHER",
        "middle_name": "NEAL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-18",
        "last_updated": "2017-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OK",
            "license": "6187",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shawnee, OK

Sources for this page

Verify at the official NPI Registry.