Christian Andrus, DMD

Individual provider Active NPI General Practice Dentistry · Glenpool, OK

NPI 1972953149 · NPPES record last updated Sep 8, 2024

Key facts

NPI
1972953149
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
6864 (OK)
Practice address
12190 S Waco Ave Ste B
Glenpool, OK 74033-5661
Phone
(951) 533-0163
NPI assigned
Jun 17, 2016
Sex
Male
Sole proprietor
No

Organizations & group practices 2

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Tulsa City Dental TCD, PLLC General Practice Current
since Sep 15, 2024
Accepting new patients
Okc Dental Health Associates, P.C. General Practice Past Accepting new patients

Locations

5639 E 41st St
Tulsa, OK 74135
Phone (918) 622-3353

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 6864 OK Yes

Addresses

Primary practice location

12190 S Waco Ave Ste B
Glenpool, OK 74033-5661

Mailing address

14001 S Joplin Ave
Bixby, OK 74008-4155
Phone (951) 533-0163

Other practice location 1

5639 E 41st St
Tulsa, OK 74135-6010
Phone (918) 622-3353

Other providers in Glenpool, OK

All providers in Glenpool, OK · General Practice Dentistry in Oklahoma

Sources for this page

Verify at the official NPI Registry.