Provider Demographics
NPI:1679364707
Name:LALONDE, JACOB JOSEPH (DDS)
Entity type:Individual
Prefix:
First Name:JACOB
Middle Name:JOSEPH
Last Name:LALONDE
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 1:3725 S WESTERN AVE UNIT 725
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73109-3401
Mailing Address - Country:US
Mailing Address - Phone:405-400-2670
Mailing Address - Fax:
Practice Address - Street 1:3725 S WESTERN AVE UNIT 725
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73109-3401
Practice Address - Country:US
Practice Address - Phone:405-400-2670
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-16
Last Update Date:2025-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK80701223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice