Provider Demographics
NPI:1689908121
Name:GROVES, JOHN E (DDS)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:E
Last Name:GROVES
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 1:10125A SOUTH SHERIDAN RD
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74134
Mailing Address - Country:US
Mailing Address - Phone:918-299-7474
Mailing Address - Fax:918-299-7480
Practice Address - Street 1:10125A SOUTH SHERIDAN RD
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74134
Practice Address - Country:US
Practice Address - Phone:918-299-7474
Practice Address - Fax:918-299-7480
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-01
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK6154122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist