Provider Demographics
NPI:1477705069
Name:OKI, JENNIFER (DMD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:
Last Name:OKI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8401 OSUNA RD NE
Mailing Address - Street 2:STE E
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111-2074
Mailing Address - Country:US
Mailing Address - Phone:505-884-6408
Mailing Address - Fax:505-872-3065
Practice Address - Street 1:8401 OSUNA RD NE
Practice Address - Street 2:STE E
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87111-2074
Practice Address - Country:US
Practice Address - Phone:505-884-6408
Practice Address - Fax:505-872-3065
Is Sole Proprietor?:No
Enumeration Date:2008-10-15
Last Update Date:2011-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ76711223G0001X
NMDD34171223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice