Healthcare Provider Details

I. General information

NPI: 1831460427
Provider Name (Legal Business Name): DENESHA MENDENHALL BS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/13/2012
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 N POPLAR LN
MIDWEST CITY OK
73130-2932
US

IV. Provider business mailing address

PO BOX 12978
OKLAHOMA CITY OK
73157-2978
US

V. Phone/Fax

Practice location:
  • Phone: 405-926-0842
  • Fax:
Mailing address:
  • Phone: 405-926-0842
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code156F00000X
TaxonomyTechnician/Technologist
License Number
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: