Provider Demographics
NPI:1467562785
Name:OLIVER, STEVEN D (DDS)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:D
Last Name:OLIVER
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 1:6540 E 121ST ST., STE A
Mailing Address - Street 2:
Mailing Address - City:BIXBY
Mailing Address - State:OK
Mailing Address - Zip Code:74008
Mailing Address - Country:US
Mailing Address - Phone:918-364-7873
Mailing Address - Fax:918-364-7874
Practice Address - Street 1:6540 E 121ST ST.,
Practice Address - Street 2:SUITE A
Practice Address - City:BIXBY
Practice Address - State:OK
Practice Address - Zip Code:74008
Practice Address - Country:US
Practice Address - Phone:918-364-7873
Practice Address - Fax:918-364-7874
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK49801223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice