Provider Demographics
NPI:1225254816
Name:SPARKS, DONNA L (DDS)
Entity Type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:L
Last Name:SPARKS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2126 REYNOLDS CT
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73069-5135
Mailing Address - Country:US
Mailing Address - Phone:405-364-1612
Mailing Address - Fax:
Practice Address - Street 1:420 24TH AVE SW
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-5110
Practice Address - Country:US
Practice Address - Phone:405-329-6603
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK52771223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice