Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1588658470 Individual Practitioner Male Practitioner

Dr. Lars Olav Bouma , DDS, MS

Dentist - General Practice • Oklahoma City, OK

Professional Overview & Biography Verified Profile Summary

Dr. Lars Bouma, DDS, MS is a registered healthcare professional specializing in Dentist - General Practice in Oklahoma City, OK. Practice services are available at 4517 MEMORIAL CIR under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

4517 Memorial Cir

Oklahoma City, OK 731425004

Telephone 4057557777
Fax 4057557169
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Oklahoma City, OK

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 35.5 Yrs
State Avg: 17.8 Yrs
Regional Practice Density
358 Specialists

Practicing in Oklahoma City, OK (1496 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License TX 18073

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.

Dentist - Prosthodontics

NUCC Taxonomy Code: 1223P0700X

State License OK PROSTHODONTICS 30

That branch of dentistry pertaining to the restoration and maintenance of oral functions, comfort, appearance and health of the patient by the restoration of natural teeth and/or the replacement of missing teeth and contiguous oral and maxillofacial tissues with artificial substitutes.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

2 Associated Practitioners
Dr. Susan Brackett , DDS

Dentist - Prosthodontics

NPI 1477562999

Doctor of Dental Surgery

Dr. Thomas Mcgarry , DDS

Dentist - Prosthodontics

NPI 1821007337

Doctor of Dental Surgery

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 11, 2025

Dentist (License #PROSTHODONTICS 30 in OK)

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

📍
Updated Practice Location July 08, 2007

Registered at 4517 MEMORIAL CIR, OKLAHOMA CITY, OK 731425004 (Tel: 4057557777)

📍
Updated Business Mailing Address July 08, 2007

Registered at 4604 NW 161ST ST, EDMOND, OK 730133250 (Tel: 4052855937)

👤
Provider Name / Credentials Updated July 08, 2007

Recorded as LARS BOUMA, DDS, MS

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Dentist (License #18073 in TX)

🟢
Initial NPI Registration & Enumeration September 07, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

0 Reviews
No patient reviews submitted yet for Dr. Lars Bouma. Be the first to share your experience!

Sign in to leave a review for Dr. Lars Bouma

Only verified registered users can submit ratings, post feedback, and upload facility photos.

NPI Administrative Meta

NPI Number: 1588658470
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 07, 2005
Last Update: September 11, 2025
Sole Proprietor: Yes

Mailing Address

4604 Nw 161st St

Edmond, OK 730133250

Phone: 4052855937

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.