Healthcare Provider Details

I. General information

NPI: 1548478381
Provider Name (Legal Business Name): ANAND N. PATEL P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4550 S HARVARD AVE
TULSA OK
74135-2906
US

IV. Provider business mailing address

4550 S HARVARD AVE
TULSA OK
74135-2906
US

V. Phone/Fax

Practice location:
  • Phone: 918-749-8817
  • Fax: 918-749-8843
Mailing address:
  • Phone: 918-749-8817
  • Fax: 918-749-8843

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number5527
License Number StateOK

VIII. Authorized Official

Name: DR. ANAND N. PATEL
Title or Position: ORTHODONTIST
Credential: D.D.S., M.S.
Phone: 918-749-8817