Sudberry Dental

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5443 Issued in OK

Legal business name

SUDBERRY DENTAL

Practice address

1520 N Commerce St Ste a
Ardmore, OK 73401-1858

Phone

(580) 226-1515

Fax

(580) 226-1516

NPI assigned

Jun 22, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Thomas Blake Sudberry, D.D.SNPI 1801081534

Title

Dentiist

Phone

(580) 226-1515

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Thomas Blake Sudberry, D.D.S.

  • General Practice Dentistry
  • Ardmore, OK
  • NPI 1801081534
  NPD Authorized official

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

{
    "created_epoch": "1308700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308700800000",
    "number": "1962798595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1520 N COMMERCE ST STE A",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734011858",
            "telephone_number": "580-226-1515",
            "fax_number": "580-226-1516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 N COMMERCE ST STE A",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734011858",
            "telephone_number": "580-226-1515",
            "fax_number": "580-226-1516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUDBERRY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-22",
        "last_updated": "2011-06-22",
        "status": "A",
        "authorized_official_last_name": "SUDBERRY",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "BLAKE",
        "authorized_official_title_or_position": "DENTIIST",
        "authorized_official_telephone_number": "580-226-1515",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "OK",
            "license": "5443",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1801081534",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pamela Louise Stout, RN, IBCLC
• Shane Stovall, RPT
• Carly Strus, APRN, CNP
• Carol M Stuart, B.S.
• Gregory R Stubbs
• Thomas Blake Sudberry, D.D.S.
• Lisa Sudderth
• April Dawn Sullivan, PA-C
• Ruben L Sunga Jr., M.D.
• Hallie Swain

• General Practice Dentistry in Ardmore, OK
• Providers in Ardmore, 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 Jun 22, 2011; 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.