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General NPI Number Information
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NPI Number | 1003314329
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Entity Type | Individual
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Provider Name | SEBASTIAN GUTIERREZ DE PINERES DDS, MD
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Gender | Male
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Dates
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Enumeration Date | 02/01/2018
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Last Update Date | 07/23/2024
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Provider Practice Location Address
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Address Line | 5510 E 41ST ST STE C
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City | TULSA
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State | OK
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Zip | 74135-6037
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Country | US
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Telephone | 918-641-4635
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Fax |
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Provider Business Mailing Address
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Address Line | 7322 E 91ST ST
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City | TULSA
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State | OK
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Zip | 74133-6016
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Country | US
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Telephone | 305-979-0631
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 244
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License Number State | OK
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Taxonomy #3
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 7866
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License Number State | OK
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