Kyle Landon Serfoss, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5881 Issued in OK

Practice address

810 W Gary Blvd
Clinton, OK 73601-2720

Phone

(580) 323-0763

Fax

(580) 323-5532

NPI assigned

Jul 9, 2006

Last updated

Aug 22, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Kyle L. Serfoss, DDS, PLLC

  • General Practice Dentistry
  • Clinton, OK
  • NPI 1619155371
  NPD (past) Authorized official
• Clinton Dental Group PLLC

  • General Practice Dentistry
  • Clinton, OK
  • NPI 1558139345
  NPD

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566432000000",
    "number": "1942233044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 725",
            "city": "CLINTON",
            "state": "OK",
            "postal_code": "736010725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 W GARY BLVD",
            "city": "CLINTON",
            "state": "OK",
            "postal_code": "736012720",
            "telephone_number": "580-323-0763",
            "fax_number": "580-323-5532"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2605 E Main St",
            "address_purpose": "LOCATION",
            "city": "Weatherford",
            "state": "OK",
            "postal_code": "730962639",
            "country_code": "US",
            "telephone_number": "580-772-0294",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SERFOSS",
        "first_name": "KYLE",
        "middle_name": "LANDON",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-09",
        "last_updated": "2019-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OK",
            "license": "5881",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leigh Renee Sawyer
• Devin Paul Schoonmaker, D.D.S.
• Deidre M Scott
• Brittany Nicole Sears
• Theresa J Sellers, RN
• Jamie Lyn Shaddon, PHARMD
• Sharad S Swami M.D., Inc. (Prime Care Family Practice)
• Kevin Dale Shavor, BS/BHRS
• Susan Shephard
• Shepherd Home Health & Hospice LLC

• General Practice Dentistry in Clinton, OK
• Providers in Clinton, 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 Aug 22, 2019; 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.