Jacob William Buster Mendenhall
Oral and Maxillofacial Surgeon Oral & Maxillofacial Surgeon
10900 Hefner Pointe Dr Suite 204
Oklahoma City
, Oklahoma 73120-5082
Jacob William Buster Mendenhall
Oral and Maxillofacial Surgeon Oral & Maxillofacial Surgeon
10900 Hefner Pointe Dr Suite 204
Oklahoma City
, Oklahoma 73120-5082
(405) 463-0010
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About
Features
Specialties
- Oral and Maxillofacial Surgeon
- Oral & Maxillofacial Surgeon
Languages spoken
- English
Location
First Address
- Jacob William Buster Mendenhall
- 10900 Hefner Pointe Dr Suite 204
- Oklahoma City, OK
- Zip : 73120-5082
- Fax : (405) 463-0010
- Phone : (405) 463-0004
Second Address
- Jacob William Buster Mendenhall
- 10900 Hefner Pointe Dr Suite 204
- Oklahoma City, OK
- Zip : 73120-5082
- Fax : (405) 463-0010
- Phone : (405) 463-0044
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223S0112X | Oral and Maxillofacial Surgeon | 148 | OK |
| N | 204E00000X | Oral & Maxillofacial Surgeon | 5823 | OK |
National Provider Identifier
| NPI | 1033252937 |
|---|---|
| Provider Name | Jacob William Buster Mendenhall |
| First Address | Oklahoma City, OK 73120-5082 |
| Second Address | Oklahoma City, OK 73120-5082 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 14/02/2007 |
| Last Update Date | 08/12/2010 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 200185210A | (05) | OK |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.