Individual provider Active NPI

Jim D Spurgeon, DDS

  • General Practice Dentistry
  • Norman, OK
National Provider Identifier
1912126491
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
4895 Issued in OK
Practice address
550 24TH Ave SW
Norman, OK 73069-5106
Phone
(405) 364-7385
Fax
(405) 447-8888
NPI assigned
Apr 24, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 4895 OK Primary

Addresses

Primary practice location

550 24TH Ave SW
Norman, OK 73069-5106

Mailing address

550 24TH Ave SW
Norman, OK 73069-5106
Phone (405) 364-7385

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20160705001082 OK Order and Referring Only - DentistPractitioner - Dentist 5890087274

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4895OKMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Smile Solutions, PLLC Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1912126491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 24TH AVE SW",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730695106",
            "telephone_number": "405-364-7385",
            "fax_number": "405-447-8888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 24TH AVE SW",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730695106",
            "telephone_number": "405-364-7385",
            "fax_number": "405-447-8888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPURGEON",
        "first_name": "JIM",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OK",
            "license": "4895",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norman, OK

Sources for this page

Verify at the official NPI Registry.