DR. COURTNEY MICKLE-DITTRICH DMD
NPI 1376230698
Dentist - General Practice in Tulsa, OK

Q: What is Courtney Mickle-dittrich's NPI number?

The NPI number for Courtney Mickle-dittrich is 1376230698. It was assigned to this individual provider in the NPPES registry on April 18, 2023.

Q: What is Courtney Mickle-dittrich's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Active since April 18, 2023PECOS Enrolled

1334 N LANSING AVE, TULSA, OK 74106(918) 587-2171 Get Directions Write a Review

NPPES record last updated: September 26, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

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About Dr. Courtney Mickle-dittrich Dmd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. COURTNEY MICKLE-DITTRICH DMD (NPI 1376230698) is an individual general practice provider in Tulsa, Oklahoma, licensed in Oklahoma (7904) and active in the NPI registry since April 2023. She is enrolled in Medicare PECOS and maintains a secondary practice location in Bolivia.

NPPES Registry Identity

NPI1376230698

Entity TypeIndividualFemale

Primary Taxonomy1223G0001X

Provider Legal NameDR. COURTNEY MICKLE-DITTRICHCredential: DMD

Location Address1334 N LANSING AVETulsa, OK 74106-5907

Mailing Address9527 N 143rd East CtOwasso, OK 74055-4950

Phone(918) 587-2171

Sole ProprietorNo

Enumeration DateApril 18, 2023

Last NPPES UpdateSeptember 26, 2024

NPPES CertifiedSeptember 26, 2024

✔ NPI 1376230698 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDentist · General PracticeDental Providers

Taxonomy Code1223G0001X

License✔ Licensed in OK · 7904

Definition

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.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

1334 N LANSING AVE, Tulsa, OK 74106

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Secondary Practice Location 1

Location 1100 Brunswick Medical Center Pkwy NEBolivia, NC 28422-1001 · Phone (910) 253-9000

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Sunflower Health Plan, Ambetter from Superior HealthPlan and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Courtney Mickle-dittrich Dmd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Courtney Mickle-dittrich reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Morton Comprehensive Health Services, Inc

Same address

Federally Qualified Health Center (FQHC)

1334 N LANSING AVE
Tulsa, OK 74106

Reassigned Medicare billing, Oklahoma enrollment
42 clinicians in this Medicare group

NPI 1275528085 (918) 587-2171

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 74106 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$82.46 typical visit price

range $53.00 – $162.61

Typical copayment $20.61 (range $13.25 – $40.65)

Most-billed visit code 99203

Established Patient

$66.48 typical visit price

range $16.68 – $132.40

Typical copayment $16.62 (range $4.17 – $33.10)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CARTER G BRASHEARS PHARMD

Pharmacist