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General NPI Number Information
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NPI Number | 1245916527
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Entity Type | Individual
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Provider Name | LENA PEREZ
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Gender | Female
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Dates
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Enumeration Date | 06/22/2023
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Last Update Date | 06/22/2023
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Provider Practice Location Address
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Address Line | 11720 E 21ST ST
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City | TULSA
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State | OK
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Zip | 74129-1833
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Country | US
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Telephone | 918-437-9111
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Fax | 918-437-1684
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Provider Business Mailing Address
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Address Line | 400 RIVERWALK TER STE 250
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City | JENKS
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State | OK
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Zip | 74037-5619
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Country | US
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Telephone | 918-998-0996
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 7770
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License Number State | OK
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