Individual provider Active NPI

James O Corwin, DDS

  • General Practice Dentistry
  • Bristow, OK
National Provider Identifier
1982647574
Registry record updated Apr 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
4993 Issued in OK
Practice address
221 E 7TH Ave
Bristow, OK 74010-2503
Phone
(918) 367-3290
NPI assigned
Jun 13, 2006
Last updated
Apr 13, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 13, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 4993 OK Primary

Addresses

Primary practice location

221 E 7TH Ave
Bristow, OK 74010-2503

Mailing address

221 E 7TH Ave
Bristow, OK 74010-2503
Phone (918) 367-3290

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231208002004 OK Order and Referring Only - DentistPractitioner - Dentist 6800117847

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4993OKMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Corwin Family Dentistry 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428883200000",
    "number": "1982647574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 E 7TH AVE",
            "city": "BRISTOW",
            "state": "OK",
            "postal_code": "740102503",
            "telephone_number": "918-367-3290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 E 7TH AVE",
            "city": "BRISTOW",
            "state": "OK",
            "postal_code": "740102503",
            "telephone_number": "918-367-3290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORWIN",
        "first_name": "JAMES",
        "middle_name": "O",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-13",
        "last_updated": "2015-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OK",
            "license": "4993",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bristow, OK

Sources for this page

Verify at the official NPI Registry.