Provider Demographics
NPI:1649391509
Name:BILLMAN, RONALD KEITH (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:KEITH
Last Name:BILLMAN
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 1:13919B N MAY AVE # 174
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73134-5035
Mailing Address - Country:US
Mailing Address - Phone:405-924-0035
Mailing Address - Fax:405-242-3014
Practice Address - Street 1:608 NW 138TH ST
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-1963
Practice Address - Country:US
Practice Address - Phone:405-924-0035
Practice Address - Fax:405-672-6512
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2011-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK49621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice