Provider Demographics
NPI:1982279139
Name:DAY, JOSEPH W (DMD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:W
Last Name:DAY
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:732 W NEW ORLEANS ST STE 132
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74011-1845
Mailing Address - Country:US
Mailing Address - Phone:918-451-9066
Mailing Address - Fax:918-451-9069
Practice Address - Street 1:9551 N OWASSO EXPY
Practice Address - Street 2:
Practice Address - City:OWASSO
Practice Address - State:OK
Practice Address - Zip Code:74055-5414
Practice Address - Country:US
Practice Address - Phone:435-881-8233
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-20
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
OK74781223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program