Healthcare Provider Details

I. General information

NPI: 1063537975
Provider Name (Legal Business Name): CARRIE D SESSOM D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2007
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7104 S SHERIDAN RD STE 8
TULSA OK
74133-2765
US

IV. Provider business mailing address

7104 S SHERIDAN RD STE 8
TULSA OK
74133-2765
US

V. Phone/Fax

Practice location:
  • Phone: 918-392-7654
  • Fax: 918-518-5760
Mailing address:
  • Phone: 918-392-7654
  • Fax: 918-518-5760

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number5239
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number5239
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: