Type 2 · Organization ✓ Active NPI ✓ Valid NPI checksum

Eastern Oklahoma Oral and Maxillofacial Surgeons

Oral and Maxillofacial Surgery (Dentist) in Broken Arrow, OK · enumerated 2014 · authorized official Angie Roe, Credentialing and Contracting.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1487074704

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Registry record

Entity type Organization (Type 2)

Legal business name Eastern Oklahoma Oral and Maxillofacial Surgeons

Practice address 4716 W Urbana St, Broken Arrow, OK, 74012

Phone (918) 449-5800

Fax (918) 455-8958

Enumeration date Apr 25, 2014

Last updated in NPPES Mar 17, 2018

Taxonomy & classification

1223S0112X Oral and Maxillofacial Surgery (Dentist) Dental Providers Primary

Authorized official

Name Angie Roe

Title Credentialing and Contracting

Phone (888) 247-1869

Other identifiers

Identifier	Type	State	Issuer
200537790A	Medicaid	OK	-
200537790B	Medicaid	OK	-

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

Where is Eastern Oklahoma Oral and Maxillofacial Surgeons located?

The practice location on file with NPPES is in Broken Arrow, OK.

How current is this record?

Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2018-03-17. Verify at npiregistry.cms.hhs.gov.

Providers at this address

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Bret Haymore Allergy & Immunology Physician · Broken Arrow, OK NPI 1376503102 Sherri Richardson Family Nurse Practitioner · Broken Arrow, OK NPI 1750530036 D. Todd Johnson DDS, PC Oral and Maxillofacial Surgery (Dentist) · Broken Arrow, OK NPI 1912221052 Breatheamerica Tulsa, LLC Allergy & Immunology Physician · Broken Arrow, OK NPI 1215254362 Ent and Sinus Solutions LLC Clinic/Center · Broken Arrow, OK NPI 1053782300 Cody Mumma Oral and Maxillofacial Surgery (Dentist) · Broken Arrow, OK NPI 1003313594 Small Group Anesthesia Services, LLC Anesthesiologist Assistant · Broken Arrow, OK NPI 1881159085

Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2018-03-17.