Provider Demographics
NPI:1174669527
Name:KIRKPATRICK & LAI DDS INC PC
Entity Type:Organization
Organization Name:KIRKPATRICK & LAI DDS INC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:AUSTIN
Authorized Official - Last Name:KIRKPATRICK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS MS
Authorized Official - Phone:918-747-1346
Mailing Address - Street 1:5304 S HARVARD AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74135-3817
Mailing Address - Country:US
Mailing Address - Phone:918-747-1346
Mailing Address - Fax:918-749-9151
Practice Address - Street 1:5304 S HARVARD AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-3817
Practice Address - Country:US
Practice Address - Phone:918-747-1346
Practice Address - Fax:918-749-9151
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK50201223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty