Provider Demographics
NPI:1003045469
Name:LANGFORD, LETA (DDS)
Entity Type:Individual
Prefix:DR
First Name:LETA
Middle Name:
Last Name:LANGFORD
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:LETA
Other - Middle Name:
Other - Last Name:CLENDENEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:60 LANDON DR
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-1772
Mailing Address - Country:US
Mailing Address - Phone:575-654-3017
Mailing Address - Fax:
Practice Address - Street 1:2305 S I-35
Practice Address - Street 2:
Practice Address - City:MOORE
Practice Address - State:OK
Practice Address - Zip Code:73160
Practice Address - Country:US
Practice Address - Phone:405-799-7529
Practice Address - Fax:405-799-0802
Is Sole Proprietor?:No
Enumeration Date:2009-07-07
Last Update Date:2014-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMDD32381223G0001X
OK64601223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice