Provider Demographics
NPI:1811761372
Name:ORTHODONTIC PARTNERS OF OKLAHOMA, PLLC
Entity type:Organization
Organization Name:ORTHODONTIC PARTNERS OF OKLAHOMA, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:J
Authorized Official - Last Name:BIRDWELL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:405-604-3745
Mailing Address - Street 1:421 NW 10TH ST STE 201E
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73103-3900
Mailing Address - Country:US
Mailing Address - Phone:405-604-3745
Mailing Address - Fax:405-655-8007
Practice Address - Street 1:421 NW 10TH ST STE 201E
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73103-3900
Practice Address - Country:US
Practice Address - Phone:405-604-3745
Practice Address - Fax:405-655-8007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-14
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty