Provider Demographics
NPI:1962684787
Name:FIELDS, LONDEL JOSEPH (DDS)
Entity Type:Individual
Prefix:
First Name:LONDEL
Middle Name:JOSEPH
Last Name:FIELDS
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 1:6281 E 120TH CT STE 400
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74137-8819
Mailing Address - Country:US
Mailing Address - Phone:918-740-0454
Mailing Address - Fax:918-970-4457
Practice Address - Street 1:6281 E 120TH CT STE 400
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74137-8819
Practice Address - Country:US
Practice Address - Phone:918-740-0454
Practice Address - Fax:918-970-4457
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-04
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK59801223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice