Provider Demographics
NPI:1619018199
Name:OAKES, DANIEL EVERETT (DDS)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:EVERETT
Last Name:OAKES
Suffix:
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 1:14 GRETTOS GAP
Mailing Address - Street 2:
Mailing Address - City:LUDLOW
Mailing Address - State:VT
Mailing Address - Zip Code:05149-9305
Mailing Address - Country:US
Mailing Address - Phone:802-228-7495
Mailing Address - Fax:
Practice Address - Street 1:14 GRETTOS GAP
Practice Address - Street 2:
Practice Address - City:LUDLOW
Practice Address - State:VT
Practice Address - Zip Code:05149-9305
Practice Address - Country:US
Practice Address - Phone:802-228-7495
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT016-00020261223G0001X
NH31481223G0001X
NY050078-11223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1005846Medicaid