Healthcare Provider Details

I. General information

NPI: 1619808086
Provider Name (Legal Business Name): SHILPA SUSAN SOJIN DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 N 15TH ST
PERRY OK
73077-5014
US

IV. Provider business mailing address

617 BERLINE DR
GUTHRIE OK
73044-4048
US

V. Phone/Fax

Practice location:
  • Phone: 580-336-2255
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number8218
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: