BEAU SPARKMAN D.D.S., P.A. (NPI# 1114292984) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114292984 |
| Entity Type | Organization |
| Organization Name | BEAU SPARKMAN D.D.S., P.A. |
| Practice Address |
104 W Ray Fine Blvd Suite 5 Roland OK 74954-5289 |
| Practice Telephone | 9185036262 |
| Mailing Telephone | 9185036262 |
| Enumeration Date | 2012-03-13 |
| Last Update Date | 2012-03-13 |
| Authorized Official Name | BEAU SPARKMAN (PRESIDENT) |
| Authorized Official Telephone | 4797394999 |
| Authorized Official Credential | D.D.S. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
6347 | OK | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 200343870A | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710442728 | Beau Sparkman D.d.s., P.a. | Clinic/Center | 400 S 18th St, Fort Smith, AR 72901-3942 | 2019-02-04 |
| Street Address |
104 W RAY FINE BLVD SUITE 5 |
| City | ROLAND |
| State | OK |
| Zip Code | 74954-5289 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437445400 | Beau E Sparkman | Dentist | 104 W Ray Fine Blvd, Ste. 5, Roland, OK 74954-5289 | 2011-06-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164969887 | Trinka Blankenship | Case Manager/Care Coordinator | 509 Dewey St, Poteau, OK 74954 | 2017-01-20 |
| 1972959625 | Karen Lynn Williams | Nurse Practitioner | 508 W. Ray Fine Blvd, Roland, OK 74954 | 2016-05-12 |
| 1285068791 | St. Madron Medical Clinic | Specialist | 205 E. Ray Fine Blvd St. 6, Roland, OK 74954 | 2013-09-03 |
| 1316178155 | Kimberley Ann Brunk | Optometrist | 1022 East Ray Fine Boulevard Suite 5, Roland, OK 74954 | 2009-07-28 |
| 1891939765 | Gary L Axley | Acupuncturist | 303 E. Ray Fine Blvd, Ste 3, Roland, OK 74954 | 2009-04-23 |
| 1598944944 | Seubold Family Chiropractic Inc | Chiropractor | 311 4 E Ray Fine Blvd, Suite4, Roland, OK 74954 | 2007-11-01 |
| 1689799793 | Cynthia Carol Almond | Preventive Medicine | 309 East Ray Fine Blvd, Roland, OK 74954 | 2007-03-20 |
| 1457498644 | Robert Kale | Anesthesiology | 100 East Ray Fine Blvd., Suite Q, Roland, OK 74954 | 2007-01-30 |
| 1255491494 | Lequita J. Joyce Inc | Counselor | 100 East Ray Fine Blvd, Roland, OK 74954 | 2006-12-11 |
| 1174604268 | Morgan A Seubold | Chiropractor | 1022 E Ray Fine Blvd, Ste 4, Roland, OK 74954 | 2006-10-17 |
| Find all providers in zip 74954 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487215828 | Allison Neumeier | Dentist | 307 E Ray Fine Blvd Ste 1, Roland, OK 74954-5160 | 2019-06-26 |
| 1437445400 | Beau E Sparkman | Dentist | 104 W Ray Fine Blvd, Ste. 5, Roland, OK 74954-5289 | 2011-06-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
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| 1114538063 | Utica Family Dentistry Pllc | Dentist | 1720 S Utica Ave, Tulsa, OK 74104-5318 | 2020-08-13 |
| 1679183420 | Dentists of Moore and Orthodontics | Dentist | 740 Sw 19th St Ste C, Moore, OK 73160-3062 | 2020-08-06 |
| 1770192635 | Joseph Ghazal | Dentist | 1520 S Main St # 1, Blackwell, OK 74631-4921 | 2020-07-27 |
| 1326656570 | Cheryl Fleming | Dentist | 7810 E. 121st St. S., Bixby, OK 74008 | 2020-07-14 |
| 1679190953 | Harmon Denture Clinic LLC | Dentist | 104 E Mcelroy Rd Ste 4, Stillwater, OK 74075-3803 | 2020-07-02 |
| 1548887946 | Hometown Dental of Yukon Pllc | Dentist | 1315 Holly Ave, Yukon, OK 73099-5407 | 2020-07-01 |
| 1093332959 | Graham Thomas Shadwick | Dentist | 1201 N Stonewall Ave Rm 241, Oklahoma City, OK 73117-1214 | 2020-06-26 |
| 1053937854 | Nathan Sethman | Dentist | 1410 N Louis Tittle Ave, Mangum, OK 73554-2218 | 2020-06-18 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.