Provider Demographics
NPI:1558550863
Name:SELLERS, JAMES ALDEN JR (DDS)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:ALDEN
Last Name:SELLERS
Suffix:JR
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 1:4608 SOUTH HARVARD AVE
Mailing Address - Street 2:STE A
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74135-2913
Mailing Address - Country:US
Mailing Address - Phone:918-742-7351
Mailing Address - Fax:
Practice Address - Street 1:4608 SOUTH HARVARD AVE
Practice Address - Street 2:STE A
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-2913
Practice Address - Country:US
Practice Address - Phone:918-742-7351
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-23
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2945122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist