Mustang Family Dental

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6183 Issued in OK

Legal business name

MUSTANG FAMILY DENTAL

Practice address

1444 N Mustang Rd
Mustang, OK 73064-7214

Phone

(405) 376-3320

Fax

(405) 376-9450

NPI assigned

Oct 1, 2015

Organization subpart

No

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

Authorized official

Name

Callie D BouzidenNPI 1649591033

Title

Dentist/Owner

Phone

(405) 376-3320

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Callie D Bouziden, D.D.S

  • Dentist
  • Tulsa, OK
  • NPI 1649591033
  NPD Authorized official

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

{
    "created_epoch": "1443657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604880000000",
    "number": "1902276025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1444 N MUSTANG RD",
            "city": "MUSTANG",
            "state": "OK",
            "postal_code": "730647214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1444 N MUSTANG RD",
            "city": "MUSTANG",
            "state": "OK",
            "postal_code": "730647214",
            "telephone_number": "405-376-3320",
            "fax_number": "405-376-9450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MUSTANG FAMILY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-01",
        "last_updated": "2020-11-09",
        "certification_date": "2020-11-09",
        "status": "A",
        "authorized_official_last_name": "BOUZIDEN",
        "authorized_official_first_name": "CALLIE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "405-376-3320"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "OK",
            "license": "6183",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1649591033",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1770996084",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kylee Lynn Munson
• Mustang Chiropractic
• Mustang Counseling Services LLC
• Mustang Dentistry & Braces
• Mustang Drug LLC
• Mustang Family Physicians PC
• Mustang Foot & Ankle Clinic, LLC
• Mustang Multispecialty Accociation
• Mustang Optical, Inc.
• Alayna Myers

• General Practice Dentistry in Mustang, OK
• Providers in Mustang, OK by specialty
• General Practice Dentistry in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2020; 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.