Healthcare Provider Details

I. General information

NPI: 1457532046
Provider Name (Legal Business Name): DENA ELAINE O'LEARY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DENA ELAINE WHITE MD

II. Dates (important events)

Enumeration Date: 11/25/2007
Last Update Date: 08/17/2023
Certification Date: 08/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4509 INTEGRIS PKWY STE 300
EDMOND OK
73034-8696
US

IV. Provider business mailing address

3001 QUAIL SPRINGS PKWY FL 5
OKLAHOMA CITY OK
73134-2640
US

V. Phone/Fax

Practice location:
  • Phone: 405-657-3704
  • Fax: 405-657-3892
Mailing address:
  • Phone: 405-657-3704
  • Fax: 405-657-3892

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License Number27720
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: