Active NPI
Thomas Bourland
- Dental Assistant
- Tulsa, OK
National Provider Identifier
1871255653
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Assistant
- Practice address
- 1620 S Elwood Ave
Tulsa, OK 74119-4248 - Phone
- (614) 706-1351
- NPI assigned
- Oct 9, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Assistant | 126800000X | Primary |
Addresses
Primary practice location
1620 S Elwood Ave
Tulsa, OK 74119-4248
Mailing address
714 N Birmingham PL
Tulsa, OK 74110-5318
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1633737600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1633737600000",
"number": "1871255653",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "714 N BIRMINGHAM PL",
"city": "TULSA",
"state": "OK",
"postal_code": "741105318"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1620 S ELWOOD AVE",
"city": "TULSA",
"state": "OK",
"postal_code": "741194248",
"telephone_number": "614-706-1351"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOURLAND",
"first_name": "THOMAS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-10-09",
"last_updated": "2021-10-09",
"certification_date": "2021-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "126800000X",
"taxonomy_group": "",
"desc": "Dental Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 Oct 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.