Provider Demographics
NPI:1528149796
Name:SEARCEY, SCOTT (DDS)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:
Last Name:SEARCEY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3727 NW 63RD
Mailing Address - Street 2:#300
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73116-1931
Mailing Address - Country:US
Mailing Address - Phone:405-848-7994
Mailing Address - Fax:405-879-6334
Practice Address - Street 1:3727 NW 63RD
Practice Address - Street 2:#300
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73116-1931
Practice Address - Country:US
Practice Address - Phone:405-848-7994
Practice Address - Fax:405-879-6334
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2012-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK50551223S0112X, 1223P0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0106XDental ProvidersDentistOral and Maxillofacial Pathology
No1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKU31049Medicare UPIN
OKV05955Medicare UPIN
OK248521403Medicare PIN
OK248522901Medicare PIN