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General NPI Number Information
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NPI Number | 1699467167
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Entity Type | Individual
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Provider Name | ELIJAH LOUIS WEISSMAN DDS
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Gender | Male
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Dates
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Enumeration Date | 05/23/2023
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Last Update Date | 05/30/2023
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Provider Practice Location Address
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Address Line | 2145 S SHERIDAN RD
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City | TULSA
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State | OK
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Zip | 74129-1001
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Country | US
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Telephone | 918-948-6965
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Fax |
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Provider Business Mailing Address
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Address Line | 3637 E 48TH PL
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City | TULSA
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State | OK
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Zip | 74135-1922
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Country | US
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Telephone | 580-695-6393
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 7739
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License Number State | OK
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