MEDICARE: SOUTHERN POINTE DENTAL AND IMPLANTS LLC

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	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1629744685
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTHERN POINTE DENTAL AND IMPLANTS LLC

Provider Business Mailing Address
First Line	:	6139 E 91ST ST
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74137-3104
Country	:	US
Telephone Number	:	918-492-8577
Fax Number	:

Provider Business Practice Location Address
First Line	:	6139 E 91ST ST
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74137-3104
Country	:	US
Telephone Number	:	918-492-8577
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MR. BRAD NELSON
Credential	:
Telephone Number	:	405-260-6080

Provider Enumeration Date	:	08/19/2021
Last Update Date	:	02/05/2024

Similar Medicare Providers

1568467504 — DR. DEBORIA FRANCES GILL D.D.S.
Practice Location Address:

6141 E 91ST ST , STE 204
TULSA, OK
74137-3104

Practice Phone: 918-747-4444
Practice Fax: 918-747-1140

1366552937 — JOSEPH L PROSKOVEC DDS PC INC
Practice Location Address:

6139 EAST 91ST STREET
TULSA, OK
74137-3104

Practice Phone: 918-491-7313
Practice Fax: 918-491-7314

1265583603 — DR. DOUGLAS S PITTMAN DDS
Practice Location Address:

6139 E 91ST ST
TULSA, OK
74137-3104

Practice Phone: 918-492-8577
Practice Fax: 918-491-7314

1043349855 — DONAL R WOODWARD DDS
Practice Location Address:

6143 E 91ST ST
TULSA, OK
74137-3104

Practice Phone: 918-492-6994
Practice Fax:

1710175484 — DONAL R WOODWARD DDS, INC.
Practice Location Address:

6143 E 91ST ST
TULSA, OK
74137-3104

Practice Phone: 918-492-6994
Practice Fax: 918-496-8711

1396197349 — JOSHUA DAVID WOODWARD DDS
Practice Location Address:

6143 E 91ST ST
TULSA, OK
74137-3104

Practice Phone: 918-492-6994
Practice Fax:

Directions to “SOUTHERN POINTE DENTAL AND IMPLANTS LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.