Healthcare Provider Details

I. General information

NPI: 1366648131
Provider Name (Legal Business Name): ELIZABETH ANN CHALOUPEK D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2007
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1420 W. OWEN K GARRIOTT RD SUITE 3
ENID OK
73703
US

IV. Provider business mailing address

1420 W. OWEN K GARRIOTT RD SUITE 3
ENID OK
73703
US

V. Phone/Fax

Practice location:
  • Phone: 580-233-1420
  • Fax: 580-233-2908
Mailing address:
  • Phone: 580-233-1420
  • Fax: 580-233-2908

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number60497
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number6443
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: