NPIMap

Organization Active NPI

Spring Dental Muskogee, PLLC

  • General Practice Dentistry
  • Muskogee, OK
National Provider Identifier
1780127969
Registry record updated Jun 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
SPRING DENTAL MUSKOGEE, PLLC
Practice address
2909 Azalea Park Dr
Muskogee, OK 74401-2283
Phone
(918) 682-0544
Fax
(918) 682-1004
NPI assigned
Nov 21, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2018

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

Authorized official

Name
Renee McBay
Title
Credentialing Specialist
Phone
(918) 998-0996

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

2909 Azalea Park Dr
Muskogee, OK 74401-2283

Mailing address

400 Riverwalk Terrace
Ste 250
Jenks, OK 74037-5619
Phone (918) 998-0996

Other names 1

  • Spring Dental Doing business as

National Provider Directory

National Provider Directory

Locations

2909 Azalea Park Dr
Muskogee, OK 74401
Phone (918) 682-0544

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": "1479686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1528934400000",
    "number": "1780127969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 RIVERWALK TERRACE",
            "address_2": "STE 250",
            "city": "JENKS",
            "state": "OK",
            "postal_code": "740375619",
            "telephone_number": "918-998-0996",
            "fax_number": "918-235-9079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2909 AZALEA PARK DR",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744012283",
            "telephone_number": "918-682-0544",
            "fax_number": "918-682-1004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPRING DENTAL MUSKOGEE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-21",
        "last_updated": "2018-06-14",
        "status": "A",
        "authorized_official_last_name": "MCBAY",
        "authorized_official_first_name": "RENEE",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "918-998-0996"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Spring Dental",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Spring Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Muskogee, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2018; 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.