Provider Demographics
NPI:1003313594
Name:MUMMA, CODY HAYES (DDS)
Entity Type:Individual
Prefix:DR
First Name:CODY
Middle Name:HAYES
Last Name:MUMMA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
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Other - Middle Name:
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Mailing Address - Street 1:2201 HEMPSTEAD TPKE
Mailing Address - Street 2:
Mailing Address - City:EAST MEADOW
Mailing Address - State:NY
Mailing Address - Zip Code:11554-1859
Mailing Address - Country:US
Mailing Address - Phone:516-572-8774
Mailing Address - Fax:
Practice Address - Street 1:4716 W URBANA ST
Practice Address - Street 2:
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74012-6162
Practice Address - Country:US
Practice Address - Phone:918-449-5800
Practice Address - Fax:918-455-8958
Is Sole Proprietor?:No
Enumeration Date:2018-04-10
Last Update Date:2022-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2291223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery