Foothills Oral & Maxillofacial Surgery

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

147 Issued in OK

Legal business name

FOOTHILLS ORAL & MAXILLOFACIAL SURGERY

Practice address

1500 E Downing St
Tahlequah, OK 74464-3234

Phone

(918) 456-0671

Fax

(918) 457-5761

NPI assigned

Jun 17, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Michael Paul Winkler, DDS, MS

Title

Ceo

Phone

(918) 457-9779

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1276732800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276732800000",
    "number": "1942521687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29062 S 558 RD",
            "city": "PARK HILL",
            "state": "OK",
            "postal_code": "744512876",
            "telephone_number": "918-457-9779",
            "fax_number": "918-457-5761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 E DOWNING ST",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744643234",
            "telephone_number": "918-456-0671",
            "fax_number": "918-457-5761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOTHILLS ORAL & MAXILLOFACIAL SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-17",
        "last_updated": "2010-06-17",
        "status": "A",
        "authorized_official_last_name": "WINKLER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "918-457-9779",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, MS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "OK",
            "license": "147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Hope Fitzgerald, RD
• Ann Lois Fladie, R.D., L.D.
• Ashley Flute
• Forrest Ray Flute
• Indian Wash a.J. Flute
• Stephanie Ford, SLP
• Kinsli Foreman
• Mallory Foreman
• Timothy Wayne Foreman
• David Alan Forsythe, CRNA

• Oral and Maxillofacial Surgery (Dentist) in Tahlequah, OK
• Providers in Tahlequah, OK by specialty
• Oral and Maxillofacial Surgery (Dentist) in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2010; 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.