Provider Demographics
NPI:1225121742
Name:CHEEK-COVEY, TENNILLE LYNN (DDS)
Entity Type:Individual
Prefix:DR
First Name:TENNILLE
Middle Name:LYNN
Last Name:CHEEK-COVEY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:TENNILLE
Other - Middle Name:LYNN
Other - Last Name:CHEEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1916 ROBIN RIDGE DRIVE
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73072
Mailing Address - Country:US
Mailing Address - Phone:405-310-2537
Mailing Address - Fax:
Practice Address - Street 1:800 S DOUGLAS BLVD
Practice Address - Street 2:
Practice Address - City:MIDWEST CITY
Practice Address - State:OK
Practice Address - Zip Code:73130-4215
Practice Address - Country:US
Practice Address - Phone:405-733-1641
Practice Address - Fax:405-733-0172
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2012-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK5599122300000X
KY7911122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK1305599Medicaid