Bwdentistry

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4740 Issued in OK

Legal business name

BWDENTISTRY

Practice address

200 E Choctaw Ave
Sallisaw, OK 74955-4604

Phone

(918) 775-3201

Fax

(918) 775-3394

NPI assigned

Aug 28, 2006

Organization subpart

No

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

Authorized official

Name

Robert Henry Wells Jr., D.D.S.NPI 1053429613

Title

President

Phone

(918) 775-3201

Specialties & licenses 1

Addresses

Locations

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.

• Robert Henry Wells Jr., D.D.S.

  • General Practice Dentistry
  • Sallisaw, OK
  • NPI 1053429613
  NPD (past) Authorized official

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

{
    "created_epoch": "1156723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1770691990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 E CHOCTAW AVE",
            "address_2": "PO BOX 625",
            "city": "SALLISAW",
            "state": "OK",
            "postal_code": "749554604",
            "telephone_number": "918-775-3201",
            "fax_number": "918-775-3394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 E CHOCTAW AVE",
            "city": "SALLISAW",
            "state": "OK",
            "postal_code": "749554604",
            "telephone_number": "918-775-3201",
            "fax_number": "918-775-3394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BWDENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WELLS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "HENRY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "918-775-3201",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "OK",
            "license": "4740",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Sallisaw, OK
• Providers in Sallisaw, 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 Aug 22, 2020; 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.