NPIMap

Organization Active NPI

Crosstown Dental Health Center, P.C.

  • General Practice Dentistry
  • Tulsa, OK
National Provider Identifier
1851708515
Registry record updated Jul 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6574 Issued in OK
Legal business name
CROSSTOWN DENTAL HEALTH CENTER, P.C.
Practice address
401 S Utica Ave
Tulsa, OK 74104-2611
Phone
(918) 599-8383
NPI assigned
Jul 15, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2014

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

Authorized official

Name
Travis Boyer
Title
Owner
Phone
(918) 599-8383

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 6574 OK Primary

Addresses

Primary practice location

401 S Utica Ave
Tulsa, OK 74104-2611

Mailing address

401 S Utica Ave
Tulsa, OK 74104-2611
Phone (918) 599-8383

Other names 1

  • SMILES 4 LIFE Doing business as

National Provider Directory

National Provider Directory

Locations

401 S Utica Ave
Tulsa, OK 74104
Phone (804) 516-7824

Practitioners & affiliated clinicians

Practitioners 2

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": "1405382400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405382400000",
    "number": "1851708515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 S UTICA AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741042611",
            "telephone_number": "918-599-8383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 S UTICA AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741042611",
            "telephone_number": "918-599-8383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROSSTOWN DENTAL HEALTH CENTER, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-15",
        "last_updated": "2014-07-15",
        "status": "A",
        "authorized_official_last_name": "BOYER",
        "authorized_official_first_name": "TRAVIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "918-599-8383"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "OK",
            "license": "6574",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SMILES 4 LIFE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tulsa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2014; 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.