Active NPI
Shane Tewis, DDS
- Dentist
- Sand Springs, OK
National Provider Identifier
1962498519
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 5533
- Practice address
- 530 Plaza CT
Sand Springs, OK 74063-7915 - Phone
- (918) 245-8333
- Fax
- (918) 245-8338
- NPI assigned
- Sep 20, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 5533 | OK | Primary |
Addresses
Primary practice location
530 Plaza CT
Sand Springs, OK 74063-7915
Mailing address
530 Plaza CT
Sand Springs, OK 74063-7915
Phone (918) 245-8333
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100126450A | Medicaid | OK |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5533 | OK | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| TNT Dental Services 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 and National Provider Directory roles.
-
- General Practice Dentistry
- Sand Springs, OK
- NPI 1073754925
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127174400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1344384000000",
"number": "1962498519",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "530 PLAZA CT",
"city": "SAND SPRINGS",
"state": "OK",
"postal_code": "740637915",
"telephone_number": "918-245-8333",
"fax_number": "918-245-8338"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "530 PLAZA CT",
"city": "SAND SPRINGS",
"state": "OK",
"postal_code": "740637915",
"telephone_number": "918-245-8333",
"fax_number": "918-245-8338"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TEWIS",
"first_name": "SHANE",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-20",
"last_updated": "2012-08-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "OK",
"license": "5533",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100126450A",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sand Springs, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.