Individual provider Active NPI

Ivey Michele Frazier, DDS

  • Dentist
  • Muskogee, OK
National Provider Identifier
1811797277
Registry record updated May 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
8075 Issued in OK
Practice address
2909 Azalea Park Dr
Muskogee, OK 74401-2283
Phone
(615) 887-9711
NPI assigned
Mar 15, 2025
Last updated
May 25, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X TN
Dentist 122300000X 8075 OK Primary

Addresses

Primary practice location

2909 Azalea Park Dr
Muskogee, OK 74401-2283

Mailing address

2909 Azalea Park Dr
Muskogee, OK 74401-2283
Phone (615) 887-9711

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

State licenses

LicenseStateTypeSpecialty
8075OKMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1741996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748131200000",
    "number": "1811797277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2909 AZALEA PARK DR",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744012283",
            "telephone_number": "615-887-9711"
        },
        {
            "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": "615-887-9711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRAZIER",
        "first_name": "IVEY",
        "middle_name": "MICHELE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-03-15",
        "last_updated": "2025-05-25",
        "certification_date": "2025-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TN",
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OK",
            "license": "8075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 May 25, 2025; 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.