Individual provider Active NPI

Yvonne Maurine Collins, DDS

  • Dentist
  • Pawnee, OK
National Provider Identifier
1871690388
Registry record updated Jan 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
4406 Issued in OK
Practice address
1201 Heritage Cir
Pawnee Indian Health Center
Pawnee, OK 74058-3744
Phone
(918) 762-6561
Fax
(918) 762-3543
NPI assigned
Sep 19, 2006
Last updated
Jan 21, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 4406 OK Primary

Addresses

Primary practice location

1201 Heritage Cir
Pawnee Indian Health Center
Pawnee, OK 74058-3744

Mailing address

1201 Heritage Cir
Pawnee Indian Health Center
Pawnee, OK 74058-3744
Phone (918) 762-6561

Other identifiers 1

IdentifierTypeStateIssuer
100112090AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151123000382 TX Order and Referring Only - DentistPractitioner - Dentist 2163722299

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4406OKMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1158624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295568000000",
    "number": "1871690388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 HERITAGE CIR",
            "address_2": "PAWNEE INDIAN HEALTH CENTER",
            "city": "PAWNEE",
            "state": "OK",
            "postal_code": "740583744",
            "telephone_number": "918-762-6561",
            "fax_number": "918-762-3543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 HERITAGE CIR",
            "address_2": "PAWNEE INDIAN HEALTH CENTER",
            "city": "PAWNEE",
            "state": "OK",
            "postal_code": "740583744",
            "telephone_number": "918-762-6561",
            "fax_number": "918-762-3543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "YVONNE",
        "middle_name": "MAURINE",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-19",
        "last_updated": "2011-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OK",
            "license": "4406",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100112090A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pawnee, OK

Sources for this page

Verify at the official NPI Registry.