Individual
DR. ALAN AKIO MIYAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, DDS
Contact information
Practice address
1201 N. STONEWALL AVE DCSB 206, OKLAHOMA CITY, OK 73117-1214
(405) 271-4441
Mailing address
1201 N. STONEWALL AVE. DCSB 206, OKLAHOMA CITY, OK 73117-1214
(405) 271-4441
(405) 271-1134
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
22636
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22636
MEDICAL LICENSE #
OK
01
—
5578
DENTAL LICENSE #
OK
Enumeration date
07/07/2006
Last updated
03/20/2014
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