NPIMap

Organization Active NPI

Enid Dentistry & Braces

  • Dental Clinic/Center
  • Enid, OK
National Provider Identifier
1780105122
Registry record updated Dec 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
6076 Issued in OK
Legal business name
ENID DENTISTRY & BRACES
Practice address
5202 W Owen K Garriott Rd Ste a
Enid, OK 73703-4611
Phone
(580) 242-5862
NPI assigned
Jul 6, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2023

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

Authorized official

Name
Dr. Benjamin James Bowman, DDS
Title
Manager
Phone
(405) 326-8004

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 6076 OK Primary

Addresses

Primary practice location

5202 W Owen K Garriott Rd Ste a
Enid, OK 73703-4611

Mailing address

5202 W Owen K Garriott Rd Ste a
Enid, OK 73703-4611
Phone (580) 242-5862

Other practice location 1

402 S Oakwood Rd Ste D
Enid, OK 73703-4945
Phone (580) 242-5862

Other identifiers 1

IdentifierTypeStateIssuer
1205032935MedicaidOK

National Provider Directory

National Provider Directory

Locations

402 S Oakwood Rd
Ste D
Enid, OK 73703
Phone (580) 242-5862

5202 W Owen K Garriott Rd
Ste A
Enid, OK 73703
Phone (580) 242-5862

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1499299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701648000000",
    "number": "1780105122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5202 W OWEN K GARRIOTT RD STE A",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737034611",
            "telephone_number": "580-242-5862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5202 W OWEN K GARRIOTT RD STE A",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737034611",
            "telephone_number": "580-242-5862"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "402 S Oakwood Rd Ste D",
            "address_purpose": "LOCATION",
            "city": "Enid",
            "state": "OK",
            "postal_code": "737034945",
            "country_code": "US",
            "telephone_number": "580-242-5862",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ENID DENTISTRY & BRACES",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-06",
        "last_updated": "2023-12-04",
        "certification_date": "2023-12-04",
        "status": "A",
        "authorized_official_last_name": "BOWMAN",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "405-326-8004",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "OK",
            "license": "6076",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1205032935",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Enid, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2023; 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.