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 | | AETNA |
| 2 | 4835 | OTHER | | BROKERS NATIONAL LIFE |
| 3 | 4835 | OTHER | | AMERITAS |
| 4 | 4835 | OTHER | | TRISURANT |
| 5 | 4835 | OTHER | | BENEFIT PLANNERS |
| 6 | 4835 | OTHER | | WASHINGTON DENTAL SERVICES |
| 7 | 4835 | OTHER | | BCBS OF ALABAMA |
| 8 | 4835 | OTHER | | DELTA DENTAL OF CALIFORNIA |
| 9 | 4835 | OTHER | | HUMANA DENTAL |
| 10 | 4835 | OTHER | | UNICARE |
| 11 | 4835 | OTHER | | BCBS OF TEXAS |
| 12 | 4835 | OTHER | | METLIFE |
| 13 | 4835 | OTHER | | FMH |
| 14 | 4835 | OTHER | | DELTA DENTAL OF RI |
| 15 | 4835 | OTHER | | KEMPTON GROUP ADMIN, INC. |
| 16 | 4835 | OTHER | | UNITED CONCORDIA |
| 17 | 4835 | OTHER | | DELTA DENTAL OF MISSOURI |
| 18 | 4835 | OTHER | | BCBS OF ILLINOIS |
| 19 | 4835 | OTHER | | MUTUAL ASSURANCE |
| 20 | 4835 | OTHER | | HARRINGTON BENEFIT SERVICES |
| 21 | 4835 | OTHER | | AIG |
| 22 | 4835 | OTHER | | GUARDIAN |
| 23 | 4835 | OTHER | | WATERSTONE |
| 24 | 4835 | OTHER | | UNITED HEALTHCARE |
| 25 | 4835 | OTHER | | FORTIS |
| 26 | 4835 | OTHER | | BCBS FEDERAL |
| 27 | 4835 | OTHER | | BCBS |
| 28 | 4835 | OTHER | | JEFFERSON PILOT |
| 29 | 4835 | OTHER | | EMPLOYERS GROUP INSURANCE |
| 30 | 4835 | OTHER | | DELTA DENTAL USA |
| 31 | 4835 | OTHER | | NTCA |
| 32 | 4835 | OTHER | | QUADMED |
| 33 | 4835 | OTHER | | DELTA DENTAL OF ILLINOIS |
| 34 | 4835 | OTHER | | CIGNA |
| 35 | 4835 | OTHER | | DELTA DENTAL OF PA |
| 36 | 4835 | OTHER | | DELTA DENTAL |
| 37 | 4835 | OTHER | | CENTRAL STATES FUNDS |
| 38 | 4835 | OTHER | | GREAT CORNERSTONE |
| 39 | 4835 | OTHER | | MAILHANDLERS |
| 40 | 4835 | OTHER | | DELTA DENTAL OF ARKANSAS |
| 41 | 4835 | OTHER | | CSCS |
| 42 | 4835 | OTHER | | DELTA DENTAL OF NEW JERSEY |
| 43 | 4835 | OTHER | | DELTA DENTAL OF COLORADO |
| 44 | 4835 | OTHER | | PRINCIPAL |
| 45 | 4835 | OTHER | | ASSURANT |
| 46 | 4835 | OTHER | | UNITED MEDICAL RESOURCES |
| 47 | 4835 | OTHER | | AMERICAN HEALTH GROUP, INC. |
| 48 | 4835 | OTHER | | APWU |
| 49 | 4835 | OTHER | | GEHA |
| 50 | 4835 | OTHER | | OSMA |
