Provider Demographics
NPI:1386850386
Name:HIGHFILL, JIM D (DDS)
Entity Type:Individual
Prefix:DR
First Name:JIM
Middle Name:D
Last Name:HIGHFILL
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 1:1781 N LONGWOOD RD
Mailing Address - Street 2:
Mailing Address - City:PONCA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:74604
Mailing Address - Country:US
Mailing Address - Phone:580-762-4860
Mailing Address - Fax:
Practice Address - Street 1:1618 N 5TH
Practice Address - Street 2:SUITE 4
Practice Address - City:PONCA CITY
Practice Address - State:OK
Practice Address - Zip Code:74601
Practice Address - Country:US
Practice Address - Phone:580-762-5335
Practice Address - Fax:580-762-5474
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3613122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist