Provider Demographics
NPI:1164504635
Name:WHEELER, NADIA (DMD)
Entity Type:Individual
Prefix:DR
First Name:NADIA
Middle Name:
Last Name:WHEELER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2321 E 3RD STREET
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74104-1831
Mailing Address - Country:US
Mailing Address - Phone:918-710-4480
Mailing Address - Fax:918-442-2080
Practice Address - Street 1:2321 E. 3RD ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74104-1831
Practice Address - Country:US
Practice Address - Phone:918-710-4480
Practice Address - Fax:918-442-2080
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2013-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK45531223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice