Provider Demographics
NPI:1851985519
Name:OSPINA, JOSHUA ANTONIO (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:ANTONIO
Last Name:OSPINA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 N STONEWALL AVE STE 230
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73117-1214
Mailing Address - Country:US
Mailing Address - Phone:405-271-4441
Mailing Address - Fax:
Practice Address - Street 1:1201 N STONEWALL AVE STE 230
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73117-1214
Practice Address - Country:US
Practice Address - Phone:405-271-4441
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-23
Last Update Date:2022-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
FLDN267731223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program