Healthcare Provider Details

I. General information

NPI: 1174458681
Provider Name (Legal Business Name): HALLIE ELIZABETH BAKER DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

1201 N STONEWALL AVE RM 242
OKLAHOMA CITY OK
73117-1214
US

IV. Provider business mailing address

6924 GENTRY CIR
EDMOND OK
73034-8481
US

V. Phone/Fax

Practice location:
  • Phone: 405-271-5222
  • Fax:
Mailing address:
  • Phone: 405-269-3623
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number8187
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: