Mendenhall, Jacob William Buster

Mendenhall, Jacob William Buster is an individual health care provider with primary practice located at 10900 Hefner Pointe Dr Suite 204, Oklahoma City OK 73120-5082. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery, Dental Providers / Oral and Maxillofacial Surgery. Dental Providers / Oral and Maxillofacial Surgery is his primary health care specialty. Mendenhall, Jacob William Buster can be contacted via phone (405) 463-0044.

Contact Information

Primary practice address
10900 Hefner Pointe Dr Suite 204 Oklahoma City OK 73120-5082
Phone: (405) 463-0044
Fax: (405) 463-0010
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery 204E00000X 5823 Oklahoma
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 148 Oklahoma

Profile Details

NPI number 1033252937
LBN Legal business name Mendenhall, Jacob William Buster
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 14th, 2007
Last updated Dec 8th, 2010 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1033252937 NPPES
Oklahoma MEDICAID 200185210A

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