MEDICARE: JACOB ROBERT SEANEY

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
1	1223G0001X	General Practice Dentistry	8246	OK

General Provider Information

NPI Number	:	1952093056
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JACOB ROBERT SEANEY

Provider Business Mailing Address
First Line	:	7801 S WESTERN AVE STE 1
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73139-2411
Country	:	US
Telephone Number	:	405-691-3399
Fax Number	:	405-256-1191

Provider Business Practice Location Address
First Line	:	7801 S WESTERN AVE STE 1
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73139-2411
Country	:	US
Telephone Number	:	405-691-3399
Fax Number	:	405-256-1191

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/25/2023
Last Update Date	:	06/12/2026

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Directions to “ JACOB ROBERT SEANEY ” Practice Location

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