Healthcare Provider Details

I. General information

NPI: 1376984567
Provider Name (Legal Business Name): JORDAN LEIGH BELL D.M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2013
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

605 RANDOLPH RD
FORT SILL OK
73503-4535
US

IV. Provider business mailing address

605 RANDOLPH RD
FORT SILL OK
73503-4535
US

V. Phone/Fax

Practice location:
  • Phone: 580-442-5925
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number019.029395
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number019.029395
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: