Provider Demographics
NPI:1801214614
Name:MAY, MICHELL (RDH)
Entity Type:Individual
Prefix:
First Name:MICHELL
Middle Name:
Last Name:MAY
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:MICHELL
Other - Middle Name:
Other - Last Name:HUDDLESTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDH
Mailing Address - Street 1:20 SW 102ND ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73139-9003
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:20 SW 102ND ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73139-9003
Practice Address - Country:US
Practice Address - Phone:405-919-1930
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-31
Last Update Date:2014-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2761124Q00000X
MD124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKN/AOtherN/A