Provider Demographics
NPI:1558657460
Name:SHYLER D. VINCENT, DDS , PROFESSIONAL DENTISTRY, PC
Entity Type:Organization
Organization Name:SHYLER D. VINCENT, DDS , PROFESSIONAL DENTISTRY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SHYLER
Authorized Official - Middle Name:D
Authorized Official - Last Name:VINCENT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:405-206-8913
Mailing Address - Street 1:6305 WATERFORD BLVD
Mailing Address - Street 2:SUITE #445
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73118-1122
Mailing Address - Country:US
Mailing Address - Phone:405-843-5885
Mailing Address - Fax:405-842-6988
Practice Address - Street 1:6305 WATERFORD BLVD
Practice Address - Street 2:SUITE #445
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73118-1122
Practice Address - Country:US
Practice Address - Phone:405-843-5885
Practice Address - Fax:405-842-6988
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-20
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK1376771196OtherINDIVIDUAL NPI #
OK1376771196OtherINDIVIDUAL NPI #