Stillwater Dentistry & Braces

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

6076

Legal business name

STILLWATER DENTISTRY & BRACES

Practice address

316 N Main St Ste 1
Stillwater, OK 74075

Phone

(405) 372-7474

Fax

(405) 372-7429

NPI assigned

Jul 10, 2017

Last updated

Jul 21, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Benjamin James Bowman, DDS

Title

Manager

Phone

(405) 326-8004

Specialties & licenses 1

Addresses

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Shanon Black, DDS

  • General Practice Dentistry
  • Stillwater, OK
  • NPI 1003549122
  NPD
• Brandan Glazier, DMD

  • General Practice Dentistry
  • Blountville, TN
  • NPI 1164261715
  NPD
• Russell Charles Brorsen, D.D.S.

  • General Practice Dentistry
  • Stillwater, OK
  • NPI 1841636586
  NPD (past)

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

{
    "created_epoch": "1499644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1962924100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "316 N MAIN ST STE 1",
            "city": "STILLWATER",
            "state": "OK",
            "postal_code": "740755548",
            "telephone_number": "405-372-7474",
            "fax_number": "405-372-7429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 N MAIN ST STE 1",
            "city": "STILLWATER",
            "state": "OK",
            "postal_code": "74075",
            "telephone_number": "405-372-7474",
            "fax_number": "405-372-7429"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "104 E McElroy Rd",
            "address_purpose": "LOCATION",
            "city": "Stillwater",
            "state": "OK",
            "postal_code": "740753803",
            "country_code": "US",
            "telephone_number": "405-372-7474",
            "fax_number": "405-372-7429",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "104 E McElroy Rd",
            "address_purpose": "LOCATION",
            "city": "Stillwater",
            "state": "OK",
            "postal_code": "740753803",
            "country_code": "US",
            "telephone_number": "405-372-7474",
            "fax_number": "405-372-7429",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "STILLWATER DENTISTRY & BRACES",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-10",
        "last_updated": "2022-07-21",
        "certification_date": "2020-10-29",
        "status": "A",
        "authorized_official_last_name": "BOWMAN",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "405-326-8004",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": "6076",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tom R Stewart, D.D.S., M.S.D.
• Stillwater Chiropractic Clinic Inc
• Stillwater Counseling Center
• Stillwater Dental and Implants, LLC
• Stillwater Dental Associates
• Stillwater Dermatology Clinic
• Stillwater Domestic Violence Services, Inc.
• Stillwater Endodontics Darrell W. Daugherty, DDS,PC
• Stillwater Eyecare Center, P.L.L.C.
• Stillwater Eyewear LLC

• Dental Clinic/Center in Stillwater, OK
• Providers in Stillwater, OK by specialty
• Dental Clinic/Center in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.