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THOMAS BLAKE SUDBERRY D.D.S.
NPI 1801081534
Dentist - General Practice in Ardmore, OK

Active since September 06, 2007Opted out of Medicare · through Dec 30, 2027
615 N. COMMERCE, ARDMORE, OK 73401(580) 223-6720 Get Directions Write a Review

NPPES record last updated: September 6, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Thomas Blake Sudberry D.d.s. NPPES

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

THOMAS BLAKE SUDBERRY D.D.S. (NPI 1801081534) is an individual general practice provider in Ardmore, Oklahoma, licensed in Oklahoma (5443) and active in the NPI registry since September 2007. He has opted out of Medicare through December 30, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1801081534
Entity TypeIndividualMale
Primary Taxonomy1223G0001X
Provider Legal NameTHOMAS BLAKE SUDBERRYCredential: D.D.S.
Location Address615 N. COMMERCEArdmore, OK 73401
Mailing Address615 N. CommerceArdmore, OK 73401 · (580) 223-6720
Phone(580) 223-6720
Sole ProprietorNo
Enumeration DateSeptember 6, 2007
✔ NPI 1801081534 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 · 5443
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.
615 N. COMMERCE, Ardmore, OK 73401
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Thomas Blake Sudberry D.d.s. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from December 30, 2015 through December 30, 2027.

Opt-Out Effective DateDecember 30, 2015
Opt-Out In Effect ThroughDecember 30, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 73401 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.

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 Thomas Sudberry's NPI number?

The NPI number for Thomas Sudberry is 1801081534. It was assigned to this individual provider in the NPPES registry on September 6, 2007.

Where is Thomas Sudberry located?

Thomas Sudberry practices at 615 N. Commerce, Ardmore, OK 73401. The listed phone number is (580) 223-6720.

What is Thomas Sudberry's specialty?

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

Is Thomas Sudberry enrolled in Medicare?

No. Thomas Sudberry has opted out of Medicare through December 30, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Thomas Sudberry was last updated on September 6, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.