STILLWATER DENTISTRY & BRACES (NPI# 1962924100) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962924100 |
| Entity Type | Organization |
| Organization Name | STILLWATER DENTISTRY & BRACES |
| Practice Address |
316 N Main St Ste 1 Stillwater OK 74075 |
| Mailing Address |
316 N Main St Ste 1 Stillwater OK 74075-5548 |
| Practice Telephone | 4053727474 |
| Practice Fax Number | 4053727429 |
| Mailing Telephone | 4053727474 |
| Mailing Fax Number | 4053727429 |
| Enumeration Date | 2017-07-10 |
| Last Update Date | 2020-10-29 |
| Authorized Official Name | BENJAMIN JAMES BOWMAN (MANAGER) |
| Authorized Official Telephone | 4053268004 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
6076 | Ambulatory Health Care Facilities |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 104 E Mcelroy Rd, Stillwater, OK 740753803 | (405) 372-7474 | 4053727429 |
| Street Address |
316 N MAIN ST STE 1 |
| City | STILLWATER |
| State | OK |
| Zip Code | 74075 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841636586 | Russell Charles Brorsen | Dentist | 316 N Main St Ste 1, Stillwater, OK 74075-5548 | 2013-05-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205495421 | Caitlyn A Lewis | Peer Specialist | 1624 Cimaron Plaza, Stillwater, OK 74075 | 2019-06-11 |
| 1861915316 | Chelsea Keel | Counselor | 3800 N Washington St, Stillwater, OK 74075 | 2017-07-17 |
| 1740475375 | Paula Dawn Evans | Marriage & Family Therapist | 110 E Lakeview Drive, Stillwater, OK 74075 | 2007-09-06 |
| 1194942102 | Trey Ratzlaff | Physical Therapy Assistant | 1810 N Perkins Road, Stillwater, OK 74075 | 2007-04-19 |
| 1629197678 | Melissa Sue Cox | Dietitian, Registered | 4700 West Mcelroy, Stillwater, OK 74075 | 2007-03-29 |
| 1033210851 | Robert Anton Crotty | Podiatrist | 120 N Perkins Rd, Ste A, Stillwater, OK 74075 | 2006-09-26 |
| 1235242074 | Ross Hospice of Ponca City, LLC | Hospice Care, Community Based | 1020 N Boomer Rd Ste 1, Stillwater, OK 74075 | 2006-08-16 |
| 1033156559 | Hac Inc | Pharmacy | 421 N. Main, Stillwater, OK 74075 | 2006-06-01 |
| 1912404583 | Hunter Elizabeth Schlosser | Case Manager/Care Coordinator | 421 E Thomas Ave, Stillwater, OK 74075 | 2018-04-10 |
| 1295246213 | Melissa Kay Wilson-watts | Case Manager/Care Coordinator | 421 E Thomas Ave, Stillwater, OK 74075 | 2017-10-17 |
| Find all providers in zip 74075 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003926007 | Stephen H Miller Dds PC | Clinic/Center | 900 South Walnut, Stillwater, OK 74074 | 2006-08-30 |
| 1427669936 | Summer Dental Stillwater, Pllc | Clinic/Center | 2200 N Perkins Rd, Stillwater, OK 74075-3076 | 2020-08-10 |
| 1215368725 | Straight Smiles, Pllc | Clinic/Center | 13961 60th St N, Stillwater, MN 55082-1053 | 2013-12-09 |
| 1245669787 | Pdg, P.a. | Clinic/Center | 13961 60th St N, Stillwater, MN 55082-1053 | 2013-11-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609474758 | Sand Springs Dentistry and Braces | Clinic/Center | 152 W. Alexander Blvd, Ste E, Sand Springs, OK 74063 | 2020-10-12 |
| 1831796580 | Perry Smiles LLC | Clinic/Center | 505 N 14th St Ste B, Perry, OK 73077-5000 | 2020-10-06 |
| 1518578095 | Summer Dental Midwest City, Pllc | Clinic/Center | 1900 S Air Depot Blvd Ste 1, Midwest City, OK 73110-5522 | 2020-08-10 |
| 1922626639 | Dental Lodge of Purcell | Clinic/Center | 1929 S Green Ave, Purcell, OK 73080-6203 | 2020-07-09 |
| 1821616533 | Enhance Dental of Norman | Clinic/Center | 1049 12th Ave Ne # 100, Norman, OK 73071-5312 | 2020-07-09 |
| 1164049185 | Custom Dental of Yukon, Pllc | Clinic/Center | 4425 Grant Blvd, Yukon, OK 73099 | 2020-06-26 |
| 1720600174 | Piedmont Dentistry & Braces | Clinic/Center | 12000 Nw Expressway, Yukon, OK 73099 | 2020-05-08 |
| 1073135588 | Yukon Dentistry & Braces | Clinic/Center | 901 E Main Street, Suite 100, Yukon, OK 73099 | 2020-05-07 |
| 1265052062 | Ada Dentistry and Braces | Clinic/Center | 931 Arlington St Ste 3, Ada, OK 74820-4025 | 2020-04-21 |
| 1225657133 | Impressions Dental of Harrah | Clinic/Center | 20926 Se 29th St Ste A, Harrah, OK 73045-6610 | 2020-04-10 |
| Find all providers with the same taxonomy | ||||
| City | STILLWATER |
| Zip Code | 74075 |
Please comment or provide details below to improve the information on STILLWATER DENTISTRY & BRACES.
| 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.