Healthcare Provider Details

I. General information

NPI: 1295851004
Provider Name (Legal Business Name): SIMS ORTHODONTICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2117 S ATLANTA PL
TULSA OK
74114-1709
US

IV. Provider business mailing address

2117 S ATLANTA PL
TULSA OK
74114-1709
US

V. Phone/Fax

Practice location:
  • Phone: 918-742-7361
  • Fax: 918-742-1822
Mailing address:
  • Phone: 918-742-7361
  • Fax: 918-742-1822

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. LAWRENCE E SIMS
Title or Position: OWNER
Credential: DDS MSD
Phone: 918-742-7361