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EASTERN OKLAHOMA ORAL AND MAXILLOFACIAL SURGEONS
NPI 1487074704
Dentist - Oral and Maxillofacial Surgery in Broken Arrow, OK

Active since April 25, 2014
4716 W URBANA ST, BROKEN ARROW, OK 74012(918) 449-5800(918) 455-8958 Get Directions Write a Review

NPPES record last updated: March 17, 2018. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 17, 2018, Nov 29, 2017 (2 updates tracked since 2017).

About Eastern Oklahoma Oral And Maxillofacial Surgeons NPPES

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

EASTERN OKLAHOMA ORAL AND MAXILLOFACIAL SURGEONS (NPI 1487074704) is a healthcare organization registered as an oral and maxillofacial surgery in Broken Arrow, Oklahoma and active in the NPI registry since April 2014. The organization maintains a secondary practice location in Owasso and lists Angie Roe, Credentialing And Contracting, as its authorized official.

NPPES Registry Identity

NPI1487074704
Entity TypeOrganization
Primary Taxonomy1223S0112X
Legal Business NameEASTERN OKLAHOMA ORAL AND MAXILLOFACIAL SURGEONS
Location Address4716 W URBANA STBroken Arrow, OK 74012-5997
Mailing Address4716 W Urbana StBroken Arrow, OK 74012-5997 · (918) 449-5800 · Fax (918) 455-8958
Phone(918) 449-5800
Fax(918) 455-8958
Organization SubpartNo
Authorized OfficialAngie RoeCredentialing And Contracting · (888) 247-1869
Enumeration DateApril 25, 2014
Last NPPES UpdateMarch 17, 20182 updates tracked since enumeration
✔ NPI 1487074704 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers
Taxonomy Code1223S0112X
Definition
An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
4716 W URBANA ST, Broken Arrow, OK 74012
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Secondary Practice Location 1

Location 112802 E 101st Pl NOwasso, OK 74055-4662 · Phone (918) 274-0944 · Fax (918) 274-1366

Other Identifiers 2

Medicaid200537790AOK
Medicaid200537790BOK

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

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

Other Providers at the Same Location NPPES 7

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

DR. CODY HAYES MUMMA DDS
Dentist (Oral and Maxillofacial Surgery)
4716 W URBANA ST
BROKEN ARROW, OK 74012
Tulsa County (918) 449-5800
ENT AND SINUS SOLUTIONS LLC
Clinic/Center
4716 W URBANA ST, SUITE B
BROKEN ARROW, OK 74012
Tulsa County (918) 872-9966
BREATHEAMERICA TULSA, LLC
Allergy & Immunology
4716 W URBANA ST, SUITE 211
BROKEN ARROW, OK 74012
Tulsa County (918) 994-5200
DR. BRET RICE HAYMORE MD
Allergy & Immunology
4716 W URBANA ST, SUITE 211
BROKEN ARROW, OK 74012
Tulsa County (918) 994-5200
MRS. SHERRI LYNN RICHARDSON DNP, APRN-CNP
Nurse Practitioner (Family)
4716 W URBANA ST
BROKEN ARROW, OK 74012
Tulsa County (918) 872-6515
SMALL GROUP ANESTHESIA SERVICES, LLC
Anesthesiologist Assistant
4716 W URBANA ST
BROKEN ARROW, OK 74012
Tulsa County (918) 704-5556
D. TODD JOHNSON DDS, PC
Dentist (Oral and Maxillofacial Surgery)
4716 W URBANA ST
BROKEN ARROW, OK 74012
Tulsa County (918) 449-5800

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Eastern Oklahoma Oral And Maxillofacial Surgeons's NPI number?

The NPI number for Eastern Oklahoma Oral And Maxillofacial Surgeons is 1487074704. It was assigned to this organization in the NPPES registry on April 25, 2014.

Where is Eastern Oklahoma Oral And Maxillofacial Surgeons located?

Eastern Oklahoma Oral And Maxillofacial Surgeons is located at 4716 W Urbana St, Broken Arrow, OK 74012. The listed phone number is (918) 449-5800.

What is Eastern Oklahoma Oral And Maxillofacial Surgeons's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

What insurance does Eastern Oklahoma Oral And Maxillofacial Surgeons accept?

Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Sunflower Health Plan, Ambetter from Superior HealthPlan and Ambetter of Oklahoma list Eastern Oklahoma Oral And Maxillofacial Surgeons as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Eastern Oklahoma Oral And Maxillofacial Surgeons was last updated on March 17, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.