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DR. JACK EDWARD WILLOUGHBY D.D.S.
NPI 1487666467
Dentist - General Practice in Edmond, OK

Active since August 11, 2006
1222 S KELLY AVE, EDMOND, OK 73003(405) 341-8518(405) 715-2494 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Jack Edward Willoughby D.d.s. NPPES

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

DR. JACK EDWARD WILLOUGHBY D.D.S. (NPI 1487666467) is an individual general practice provider in Edmond, Oklahoma, licensed in Oklahoma (4150) and active in the NPI registry since August 2006.

NPPES Registry Identity

NPI1487666467
Entity TypeIndividualMale
Primary Taxonomy1223G0001X
Provider Legal NameDR. JACK EDWARD WILLOUGHBYCredential: D.D.S.
Location Address1222 S KELLY AVEEdmond, OK 73003-5855
Mailing Address1222 S Kelly AveEdmond, OK 73003-5855 · (405) 341-8518 · Fax (405) 715-2494
Phone(405) 341-8518
Fax(405) 715-2494
Sole ProprietorNo
Enumeration DateAugust 11, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1487666467 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in OK · 4150
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.
1222 S KELLY AVE, Edmond, OK 73003
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas.Insurance ›

Other Providers at the Same Location NPPES

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

DR. GRAHAM BUSBY DDS
Dentist (General Practice)
1222 S KELLY AVE
EDMOND, OK 73003
Oklahoma County (405) 341-8518

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 Jack Willoughby's NPI number?

The NPI number for Jack Willoughby is 1487666467. It was assigned to this individual provider in the NPPES registry on August 11, 2006.

Where is Jack Willoughby located?

Jack Willoughby practices at 1222 S Kelly Ave, Edmond, OK 73003. The listed phone number is (405) 341-8518.

What is Jack Willoughby's specialty?

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

What insurance does Jack Willoughby accept?

Health plans from Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas list Jack Willoughby 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 Jack Willoughby was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.