Organization Active NPI

On the Cusp Specialty Dental PLLC

  • Pediatric Dentistry
  • Tulsa, OK
National Provider Identifier
1992368278
Registry record updated Nov 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
ON THE CUSP SPECIALTY DENTAL PLLC
Practice address
4444 S. Harvard Ave
Ste 100
Tulsa, OK 74135
Phone
(918) 970-4944
Fax
(918) 271-5618
NPI assigned
Apr 22, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2023

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

Authorized official

Name
Dr. Ryan Scott Roberts, DDS
Title
Ceo
Phone
(918) 970-4944

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X Primary

Addresses

Primary practice location

4444 S. Harvard Ave
Ste 100
Tulsa, OK 74135

Mailing address

4444 S. Harvard Ave
Ste 100
Tulsa, OK 74135
Phone (918) 970-4944

Other identifiers 1

IdentifierTypeStateIssuer
200258530AMedicaidOK

Other names 1

  • DBA On The Cusp Midtown Doing business as

National Provider Directory

National Provider Directory

Locations

4444 S Harvard Ave
Tulsa, OK 74135
Phone (918) 744-0228

NPI Registry JSON

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

{
    "created_epoch": "1555891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700611200000",
    "number": "1992368278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4444 S. HARVARD AVE",
            "address_2": "STE 100",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "74135",
            "telephone_number": "918-970-4944",
            "fax_number": "918-271-5618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4444 S. HARVARD AVE",
            "address_2": "STE 100",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "74135",
            "telephone_number": "918-970-4944",
            "fax_number": "918-271-5618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ON THE CUSP SPECIALTY DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-22",
        "last_updated": "2023-11-22",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "918-970-4944",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200258530A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DBA On The Cusp Midtown",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tulsa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2023; 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.