Individual provider Active NPI

Larry David Lander, DDS, MS

  • Oral and Maxillofacial Surgery (Dentist)
  • Tulsa, OK
National Provider Identifier
1801809629
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
3818 Issued in OK
Practice address
6132 E 61St St
Tulsa, OK 74136-2117
Phone
(918) 494-8634
Fax
(918) 494-8636
NPI assigned
Aug 14, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 3818 OK Primary

Addresses

Primary practice location

6132 E 61St St
Tulsa, OK 74136-2117

Mailing address

3111 S Columbia Cir
Tulsa, OK 74105-2329
Phone (918) 743-1809

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Jul 1, 2015 through Jul 1, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
3818OKMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Larry D. Lander D.D.S.,M.S. Inc Oral and Maxillofacial Surgery PastSince Jun 27, 2010 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801809629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3111 S COLUMBIA CIR",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741052329",
            "telephone_number": "918-743-1809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6132 E 61ST ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741362117",
            "telephone_number": "918-494-8634",
            "fax_number": "918-494-8636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDER",
        "first_name": "LARRY",
        "middle_name": "DAVID",
        "credential": "DDS, MS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "OK",
            "license": "3818",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.