Taxonomy Codes
The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:
| No. |
Taxonomy Code |
Taxonomy Clasification |
Taxonomy Specialization |
License Number |
License State |
Primary |
| 1 | 1223G0001X | Dentist | General Practice | 4835 | OKLAHOMA | Yes |
Other Identifiers
The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.
| No. |
Other Provider Identifier |
Other Provider Identifier Type |
Other Provider Identifier State |
Other Provider Identifier Issuer |
| 1 | 4835 | OTHER | | CIGNA |
| 2 | 4835 | OTHER | | MUTUAL ASSURANCE |
| 3 | 4835 | OTHER | | UNICARE |
| 4 | 4835 | OTHER | | BROKERS NATIONAL LIFE |
| 5 | 4835 | OTHER | | MAILHANDLERS |
| 6 | 4835 | OTHER | | DELTA DENTAL OF RI |
| 7 | 4835 | OTHER | | BCBS OF ALABAMA |
| 8 | 4835 | OTHER | | BCBS OF TX |
| 9 | 4835 | OTHER | | CSCS |
| 10 | 4835 | OTHER | | BLUE CROSS/BLUE SHIELD FEDERAL |
| 11 | 4835 | OTHER | | GEHA |
| 12 | 4835 | OTHER | | UNITED HEALTHCARE |
| 13 | 4835 | OTHER | | WASHINGTON DENTAL SERVICES |
| 14 | 4835 | OTHER | | AIG |
| 15 | 4835 | OTHER | | JEFFERSON PILOT |
| 16 | 4835 | OTHER | | DELTA DENTAL OF CALIFORNIA |
| 17 | 4835 | OTHER | | DELTA DENTAL USA |
| 18 | 4835 | OTHER | | DELTA DENTAL OF COLORADO |
| 19 | 4835 | OTHER | | BLUE CROSS/BLUE SHIELD |
| 20 | 4835 | OTHER | | PRINCIPAL |
| 21 | 4835 | OTHER | | UNITED MEDICAL RESOURCES |
| 22 | 4835 | OTHER | | APWU |
| 23 | 4835 | OTHER | | TRISURANT |
| 24 | 4835 | OTHER | | BENEFIT PLANNERS |
| 25 | 4835 | OTHER | | GUARDIAN |
| 26 | 4835 | OTHER | | NTCA |
| 27 | 4835 | OTHER | | DELTA DENTAL OF ARKANSAS |
| 28 | 4835 | OTHER | | DELTA DENTAL OF ILLINOIS |
| 29 | 4835 | OTHER | | DELTA DENTAL OF NEW JERSEY |
| 30 | 4835 | OTHER | | AETNA |
| 31 | 4835 | OTHER | | QUADMED |
| 32 | 4835 | OTHER | | UNITED CONCORDIA |
| 33 | 4835 | OTHER | | AMERITAS |
| 34 | 4835 | OTHER | | ASSURANT |
| 35 | 4835 | OTHER | | CENTRAL STATES FUNDS |
| 36 | 4835 | OTHER | | FMH |
| 37 | 4835 | OTHER | | OSMA |
| 38 | 4835 | OTHER | | HUMANA DENTAL |
| 39 | 4835 | OTHER | | DELTA DENTAL |
| 40 | 4835 | OTHER | | HARRINGTON BENEFIT SERVICES |
| 41 | 4835 | OTHER | | FORTIS |
| 42 | 4835 | OTHER | | DELTA DENTAL OF MISSOURI |
| 43 | 4835 | OTHER | | BCBS OF ILLINOIS |
| 44 | 4835 | OTHER | | EMPLOYERS GROUP INSURANCE |
| 45 | 4835 | OTHER | | KEMPTON GROUP ADMIN, INC. |
| 46 | 4835 | OTHER | | METLIFE |
| 47 | 4835 | OTHER | | WATERSTONE |
| 48 | 4835 | OTHER | | GREAT CORNERSTONE |
| 49 | 4835 | OTHER | | AMERICAN HEALTH GROUP, INC |
| 50 | 4835 | OTHER | | DELTA DENTAL OF PA |
