Provider Demographics
NPI:1063041275
Name:FLEMING DENTAL CO PLLC
Entity Type:Organization
Organization Name:FLEMING DENTAL CO PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:KENNETH
Authorized Official - Last Name:FLEMING
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:405-423-8846
Mailing Address - Street 1:219 ALAMOSA RD
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73069-3127
Mailing Address - Country:US
Mailing Address - Phone:405-423-8846
Mailing Address - Fax:
Practice Address - Street 1:13316 S WESTERN AVE STE B
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73170-7309
Practice Address - Country:US
Practice Address - Phone:405-423-8846
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-08
Last Update Date:2020-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental