Provider Demographics
NPI:1871169177
Name:DENISON, S JOSHUA (DDS)
Entity type:Individual
Prefix:
First Name:S
Middle Name:JOSHUA
Last Name:DENISON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:JOSHUA
Other - Middle Name:
Other - Last Name:DENISON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:400 RIVERWALK TER STE 250
Mailing Address - Street 2:
Mailing Address - City:JENKS
Mailing Address - State:OK
Mailing Address - Zip Code:74037-5619
Mailing Address - Country:US
Mailing Address - Phone:918-998-0996
Mailing Address - Fax:918-310-1056
Practice Address - Street 1:2329 E MAIN ST
Practice Address - Street 2:
Practice Address - City:CUSHING
Practice Address - State:OK
Practice Address - Zip Code:74023-2904
Practice Address - Country:US
Practice Address - Phone:918-285-5500
Practice Address - Fax:844-272-1565
Is Sole Proprietor?:No
Enumeration Date:2021-05-28
Last Update Date:2021-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK7467122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist