Provider Demographics
NPI:1346520020
Name:STIPE, DANIEL WILLIAM (DDS)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:WILLIAM
Last Name:STIPE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9025 N 121ST EAST AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:OWASSO
Mailing Address - State:OK
Mailing Address - Zip Code:74055-5399
Mailing Address - Country:US
Mailing Address - Phone:918-304-8040
Mailing Address - Fax:
Practice Address - Street 1:2838 N OLIVER ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67220-2983
Practice Address - Country:US
Practice Address - Phone:918-949-4450
Practice Address - Fax:918-794-7728
Is Sole Proprietor?:No
Enumeration Date:2011-08-25
Last Update Date:2020-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS60870122300000X
OK6327122300000X
TX339311223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist