DR. SAM BLAKE CAMPBELL (NPI# 1275190688) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275190688 |
| Entity Type | Individual |
| Full Name | DR. SAM BLAKE CAMPBELL |
| Credential | DDS |
| Practice Address |
100 S Bliss Ave Tahlequah OK 74464-2512 |
| Mailing Address |
Po Box 972 Tahlequah OK 74465-0972 |
| Practice Telephone | 9184583100 |
| Mailing Telephone | 9182075274 |
| Enumeration Date | 2019-05-21 |
| Last Update Date | 2019-05-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 7184 | OK | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205123890 | Sam William Campbell | Emergency Medicine | 1 Genesys Pkwy, Department of Cme, Grand Blanc, MI 48439-8065 | 2011-07-01 |
| Street Address |
100 S BLISS AVE |
| City | TAHLEQUAH |
| State | OK |
| Zip Code | 74464-2512 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194727198 | Owen Buck Gilmore | Family Medicine | 100 S Bliss Ave, Tahlequah, OK 74464-2512 | 2005-08-10 |
| 1669085049 | Catherine Bailey Mcguffey | Physician Assistant | 100 S Bliss Ave, Tahlequah, OK 74464-2512 | 2020-08-26 |
| 1679183404 | Kathryn Nicole Martin | Advanced Practice Midwife | 100 S Bliss Ave, Tahlequah, OK 74464-2512 | 2020-08-06 |
| 1548882103 | Stacy Lynn Rutherford | Registered Nurse | 100 S Bliss Ave, Tahlequah, OK 74464-2512 | 2020-05-17 |
| 1033739354 | Kelsey Kitchens | Audiologist | 100 S Bliss Ave, Tahlequah, OK 74464-2512 | 2020-04-17 |
| 1952930257 | Athena Chatzigiannidis | Student in an Organized Health Care Education/Training Program | 100 S Bliss Ave, Tahlequah, OK 74464-2512 | 2020-04-07 |
| 1942839394 | Sean Crawford | Student in an Organized Health Care Education/Training Program | 100 S Bliss Ave, Tahlequah, OK 74464-2512 | 2020-04-07 |
| 1912544735 | Henri Jade Casey | Dentist | 100 S Bliss Ave, Tahlequah, OK 74464-2512 | 2019-12-01 |
| 1831743624 | Sonny Jefferson James Downing | Pharmacist | 100 S Bliss Ave, Tahlequah, OK 74464-2512 | 2019-07-30 |
| 1154985869 | David Ryan Markes | Student in an Organized Health Care Education/Training Program | 100 S Bliss Ave, Tahlequah, OK 74464-2512 | 2019-04-28 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184253403 | Kendall Harris | Student in an Organized Health Care Education/Training Program | 100 Bliss Ave, Tahlequah, OK 74464 | 2020-04-07 |
| 1528609302 | Norma Brightly | Technician | 103 Sequoyah, Tahlequah, OK 74464 | 2019-10-03 |
| 1073175832 | Jody Lynn Dallis | Case Manager/Care Coordinator | Tenkiller Behavioral Services, 27753 S. Welling Rd, Welling, OK 74464 | 2019-07-02 |
| 1184287849 | Perry Jake Proctor | Student in an Organized Health Care Education/Training Program | 1400 E Downing St, Tahlequah, Ok 74464, Tahlequah, OK 74464 | 2019-04-18 |
| 1336657279 | Sidney Sheyenne Kimble | Case Manager/Care Coordinator | 1429 Jack Brown Lane, Tahlequah, OK 74464 | 2018-01-12 |
| 1891225686 | Nichols Bradley Alberty | Orthotist | 1294 East Downing, Suite 3, Tahlequah, OK 74464 | 2017-06-14 |
| 1922549690 | Krystal Easter Ms, Lpc | Counselor | 2201 Oakridge Dr, Tahlequah, OK 74464 | 2017-03-15 |
| 1144777319 | Northeastern Oklahoma Community Health Centers, Inc. | Clinic/Center | 529 N. Oak St., Tahlequah, OK 74464 | 2016-09-06 |
| 1548713456 | Clement Isioma Nwadozi | Optometrist | 3763 Southridge Cir Apt 6, Tahlequah, OK 74464 | 2016-07-27 |
| 1033532635 | Wesley Gragg | Specialist/Technologist | 603 North Grand Avenue, Tahlequah, OK 74464 | 2014-02-03 |
| Find all providers in zip 74464 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003131459 | Brant Rouse Dds Plc | Dentist | 559 Meadow Creek Drive, Tahlequah, OK 74464-1088 | 2010-03-29 |
| 1154483774 | Ann E. Riley | Dentist | 407 Daisy Dr, Suite A, Tahlequah, OK 74464 | 2006-12-14 |
| 1619070752 | Matthew Evann Walker | Dentist | 221 E. Downing St, Tahlequah, OK 74464 | 2006-09-06 |
| 1972597276 | Robert Paul Webb IIi | Dentist | 400 E Downing St, Tahlequah, OK 74464-3016 | 2005-09-01 |
| 1497373773 | Rishin Patel | Dentist | 221 E Downing St, Tahlequah, OK 74464-3011 | 2020-07-13 |
| 1295184448 | Matthew Hodgson | Dentist | 221 E Downing St, Tahlequah, OK 74464-3011 | 2016-06-08 |
| 1083963003 | Sanah Ali | Dentist | 1200 W 4th St, Tahlequah, OK 74464-5013 | 2012-09-05 |
| 1528118007 | Jeffrey Allan Stuart | Dentist | 100 S Bliss Ave, Tahlequah, OK 74464-2512 | 2007-01-10 |
| 1508929092 | Kippy Glynn Martin | Dentist | 100 S Bliss Ave, Tahlequah, OK 74464-2512 | 2006-12-18 |
| 1194888594 | Michael Francis Gmurek | Dentist | 100 S Bliss Ave, Tahlequah, OK 74464-2512 | 2006-12-18 |
| Find all providers in TAHLEQUAH | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.