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:
Health care specialties
| Specialty | Code | License # | 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 15 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1033252937 | NPPES |
| Oklahoma | MEDICAID | 200185210A |
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