Jonathan W Suttle
Individual provider Active NPI General Practice Dentistry · Okarche, OK
NPI 1679130397 · NPPES record last updated May 29, 2019
Key facts
- NPI
- 1679130397
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- OK7168 (OK)
- Practice address
- 501 N. 4TH Street
Okarche, OK 73762-0796 - Phone
- (405) 263-7603
- NPI assigned
- May 29, 2019
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OK7168 | OK | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | OK7168 | OK | Yes |
Addresses
Primary practice location
501 N. 4TH Street
Okarche, OK 73762-0796
Mailing address
PO Box 796
Okarche, OK 73762-0796
Phone (405) 263-7603
Other providers in Okarche, OK
- Saint Andre' Bessette
- Salatka Hall
- Cassidy Seely
- Eric Aaron Sowle
- Gary M. Suttle
- Thomas R Stough MD PC
- Thomas R Stough MD PC
- Kyann Woods
All providers in Okarche, OK · General Practice Dentistry in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 29, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.