Individual provider Active NPI

Joseph Ghazal

  • General Practice Dentistry
  • Broken Arrow, OK
National Provider Identifier
1770192635
Registry record updated Aug 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7367 Issued in OK
Practice address
2319 N 9TH St
Broken Arrow, OK 74012-2850
Phone
(918) 771-7164
NPI assigned
Jul 27, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 24, 2021

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 7367 OK Primary

Addresses

Primary practice location

2319 N 9TH St
Broken Arrow, OK 74012-2850

Mailing address

600 S Magnolia Ave
Broken Arrow, OK 74012-3250
Phone (918) 706-3437

Other practice location 1

1520 S Main St # 1
Blackwell, OK 74631-4921
Phone (580) 363-3075

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1595808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629763200000",
    "number": "1770192635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 S MAGNOLIA AVE",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740123250",
            "telephone_number": "918-706-3437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2319 N 9TH ST",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740122850",
            "telephone_number": "918-771-7164"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1520 S Main St # 1",
            "address_purpose": "LOCATION",
            "city": "Blackwell",
            "state": "OK",
            "postal_code": "746314921",
            "country_code": "US",
            "telephone_number": "580-363-3075",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GHAZAL",
        "first_name": "JOSEPH",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-07-27",
        "last_updated": "2021-08-24",
        "certification_date": "2021-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OK",
            "license": "7367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Broken Arrow, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2021; 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.