Active NPI
Alan Russell Dean Jr., D.C.
- Chiropractor
- Ponca City, OK
National Provider Identifier
1992730378
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 3264
- Practice address
- 313 N 4TH St
Suite 100
Ponca City, OK 74601-4554 - Phone
- (580) 765-2455
- NPI assigned
- Jul 12, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 3264 | OK | Primary |
Addresses
Primary practice location
313 N 4TH St
Suite 100
Ponca City, OK 74601-4554
Mailing address
3200 N O St
Blackwell, OK 74631-6310
Phone (580) 789-0489
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3264 | OK | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152662400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1216598400000",
"number": "1992730378",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3200 N O ST",
"city": "BLACKWELL",
"state": "OK",
"postal_code": "746316310",
"telephone_number": "580-789-0489"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "313 N 4TH ST",
"address_2": "SUITE 100",
"city": "PONCA CITY",
"state": "OK",
"postal_code": "746014554",
"telephone_number": "580-765-2455"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEAN",
"first_name": "ALAN",
"middle_name": "RUSSELL",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-12",
"last_updated": "2008-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "OK",
"license": "3264",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ponca City, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.