MEDICARE: DR. CHRISTOPHER CHARLES VINSON D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	6062	OK

General Provider Information

NPI Number	:	1427212372
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTOPHER CHARLES VINSON D.D.S.

Provider Business Mailing Address
First Line	:	5119 E 81ST ST STE A
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74137-2292
Country	:	US
Telephone Number	:	918-492-1917
Fax Number	:	918-492-4538

Provider Business Practice Location Address
First Line	:	7104 S SHERIDAN RD STE 8
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74133-2765
Country	:	US
Telephone Number	:	918-492-3752
Fax Number	:	918-492-4538

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/10/2008
Last Update Date	:	04/14/2021

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