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NPI Code Detail

MEDICARE: JONAH HALSELL DMD

MEDICARE:   JONAH  HALSELL  DMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist8259OK

General Provider Information

NPI Number : 1538859558
Entity Type Code : Individual
Provider Name (Legal Business Name) : JONAH HALSELL DMD
Provider Business Mailing Address
First Line : 710 W 71ST ST
Second Line :
City : TULSA
State : OK
Zip : 74132-1825
Country : US
Telephone Number : 918-236-7123
Fax Number : 918-998-0818
Provider Business Practice Location Address
First Line : 710 W 71ST ST
Second Line :
City : TULSA
State : OK
Zip : 74132-1825
Country : US
Telephone Number : 918-236-7123
Fax Number : 918-998-0818
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/11/2023
Last Update Date : 06/11/2026

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Directions to “ JONAH HALSELL DMD” Practice Location

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