Provider Demographics
NPI:1235210220
Name:SCOTT, MEGANN WAKELEE (DDS)
Entity Type:Individual
Prefix:
First Name:MEGANN
Middle Name:WAKELEE
Last Name:SCOTT
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 1:206 W. 6TH
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:OK
Mailing Address - Zip Code:74074
Mailing Address - Country:US
Mailing Address - Phone:405-707-6135
Mailing Address - Fax:405-707-0602
Practice Address - Street 1:47 NE 23RD
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73105
Practice Address - Country:US
Practice Address - Phone:405-601-2763
Practice Address - Fax:405-601-3783
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2010-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK59131223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice