Provider Demographics
NPI:1568734622
Name:PARADIGM DENTAL SOLUTIONS, INC.
Entity Type:Organization
Organization Name:PARADIGM DENTAL SOLUTIONS, INC.
Other - Org Name:EARNEST L. LEWIS,DDS
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:EARNEST
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:918-893-2400
Mailing Address - Street 1:2221 W WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74012-6726
Mailing Address - Country:US
Mailing Address - Phone:918-893-2400
Mailing Address - Fax:918-893-2444
Practice Address - Street 1:2221 W WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74012-6726
Practice Address - Country:US
Practice Address - Phone:918-893-2400
Practice Address - Fax:918-893-2444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-06
Last Update Date:2012-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4256122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty