Individual provider Active NPI

Brad Cummings, D.D.S.

  • General Practice Dentistry
  • Oklahoma City, OK
National Provider Identifier
1932652344
Registry record updated Dec 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6893 Issued in OK
Practice address
6400 SW 3Rd St
Ste B
Oklahoma City, OK 73128-2206
Phone
(405) 458-5822
NPI assigned
Aug 2, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 100584 CA
General Practice Dentistry 1223G0001X 6893 OK Primary

Addresses

Primary practice location

6400 SW 3Rd St
Ste B
Oklahoma City, OK 73128-2206

Mailing address

2401 San Marco LN
Edmond, OK 73034-2354
Phone (909) 747-9482

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
I20170112000241 OK Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 2567743248

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6893OKMDProfessional Counselor
100584CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1470096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480550400000",
    "number": "1932652344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 SAN MARCO LN",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730342354",
            "telephone_number": "909-747-9482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6400 SW 3RD ST",
            "address_2": "STE B",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731282206",
            "telephone_number": "405-458-5822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUMMINGS",
        "first_name": "BRAD",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-02",
        "last_updated": "2016-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "100584",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OK",
            "license": "6893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.