Provider Demographics
NPI:1386923423
Name:PINKSTON, BENJAMIN DEAN (DDS)
Entity type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:DEAN
Last Name:PINKSTON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2821 NW 57TH ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-7046
Mailing Address - Country:US
Mailing Address - Phone:405-843-9731
Mailing Address - Fax:405-843-9743
Practice Address - Street 1:2821 NW 57TH ST
Practice Address - Street 2:SUITE 100
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-7046
Practice Address - Country:US
Practice Address - Phone:405-843-9731
Practice Address - Fax:405-843-9743
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-08
Last Update Date:2013-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK62951223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice