Provider Demographics
NPI:1548228174
Name:KIERL, JAMES PETER (DDS MS)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:PETER
Last Name:KIERL
Suffix:
Gender:M
Credentials:DDS MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:171 SE 33RD ST
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-4602
Mailing Address - Country:US
Mailing Address - Phone:405-341-5020
Mailing Address - Fax:405-341-0271
Practice Address - Street 1:171 SE 33RD ST
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-4602
Practice Address - Country:US
Practice Address - Phone:405-341-5020
Practice Address - Fax:405-341-0271
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK42041223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics