Provider Demographics
NPI:1487667093
Name:LAVELETT, LARRY J (DDS)
Entity Type:Individual
Prefix:DR
First Name:LARRY
Middle Name:J
Last Name:LAVELETT
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:443 12TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73071-5241
Mailing Address - Country:US
Mailing Address - Phone:405-360-0018
Mailing Address - Fax:405-360-1178
Practice Address - Street 1:443 12TH AVE. N.E.
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73071-5241
Practice Address - Country:US
Practice Address - Phone:405-360-0018
Practice Address - Fax:405-360-1178
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-14
Last Update Date:2008-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK48351223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
4835OtherBLUE CROSS/BLUE SHIELD FEDERAL
4835OtherNTCA
4835OtherQUADMED
4835OtherCENTRAL STATES FUNDS
4835OtherDELTA DENTAL OF ILLINOIS
4835OtherCSCS
4835OtherMETLIFE
4835OtherDELTA DENTAL OF NEW JERSEY
4835OtherGEHA
4835OtherMUTUAL ASSURANCE
4835OtherUNITED MEDICAL RESOURCES
4835OtherAMERITAS
4835OtherGREAT CORNERSTONE
4835OtherGUARDIAN
4835OtherPRINCIPAL
4835OtherWATERSTONE
4835OtherASSURANT
4835OtherMAILHANDLERS
4835OtherDELTA DENTAL USA
4835OtherAIG
4835OtherOSMA
4835OtherEMPLOYERS GROUP INSURANCE
4835OtherKEMPTON GROUP ADMIN, INC.
4835OtherUNICARE
4835OtherFMH
4835OtherFORTIS
4835OtherTRISURANT
4835OtherAMERICAN HEALTH GROUP, INC
4835OtherBCBS OF ALABAMA
4835OtherAETNA
4835OtherCIGNA
4835OtherDELTA DENTAL
4835OtherHARRINGTON BENEFIT SERVICES
4835OtherUNITED CONCORDIA
4835OtherWASHINGTON DENTAL SERVICES
4835OtherJEFFERSON PILOT
4835OtherDELTA DENTAL OF ARKANSAS
4835OtherDELTA DENTAL OF MISSOURI
4835OtherDELTA DENTAL OF RI
4835OtherDELTA DENTAL OF COLORADO
4835OtherBCBS OF TX
4835OtherBCBS OF ILLINOIS
4835OtherBLUE CROSS/BLUE SHIELD
4835OtherBENEFIT PLANNERS
4835OtherUNITED HEALTHCARE
4835OtherAPWU
4835OtherBROKERS NATIONAL LIFE
4835OtherDELTA DENTAL OF CALIFORNIA
4835OtherDELTA DENTAL OF PA
4835OtherHUMANA DENTAL