Healthcare Provider Details

I. General information

NPI: 1922590900
Provider Name (Legal Business Name): CHRISTY LEIGH HEINZE DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/05/2018
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 N DIVISION ST
GUTHRIE OK
73044-3203
US

IV. Provider business mailing address

303 N DIVISION ST
GUTHRIE OK
73044-3203
US

V. Phone/Fax

Practice location:
  • Phone: 405-282-8120
  • Fax:
Mailing address:
  • Phone: 405-282-8120
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number7047
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: