Provider Demographics
NPI:1508023383
Name:THAI-AN DOAN D.D.S. P.C.
Entity Type:Organization
Organization Name:THAI-AN DOAN D.D.S. P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:THAI-AN
Authorized Official - Middle Name:
Authorized Official - Last Name:DOAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:405-752-5437
Mailing Address - Street 1:11318 N MAY AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73120-5860
Mailing Address - Country:US
Mailing Address - Phone:405-752-5437
Mailing Address - Fax:405-748-6684
Practice Address - Street 1:11318 N MAY AVE
Practice Address - Street 2:SUITE B
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-5860
Practice Address - Country:US
Practice Address - Phone:405-752-5437
Practice Address - Fax:405-748-6684
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-20
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK54611223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty