Provider Demographics
NPI:1891829032
Name:LIM, HENG L (DDS)
Entity Type:Individual
Prefix:DR
First Name:HENG
Middle Name:L
Last Name:LIM
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 1:8801 N 145TH EAST AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:OWASSO
Mailing Address - State:OK
Mailing Address - Zip Code:74055-8464
Mailing Address - Country:US
Mailing Address - Phone:918-274-3779
Mailing Address - Fax:918-274-4246
Practice Address - Street 1:8801 N 145TH EAST AVE
Practice Address - Street 2:SUITE A
Practice Address - City:OWASSO
Practice Address - State:OK
Practice Address - Zip Code:74055-8464
Practice Address - Country:US
Practice Address - Phone:918-274-3779
Practice Address - Fax:918-274-4246
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK12Other32