IndividualActive
Justin Pisano, D.D.S.
NPI 1477927085 · Oral and Maxillofacial Surgery (Dentist) · Oklahoma City, OK
Provider details
- NPI number
- 1477927085
- Entity type
- Individual
- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)Dental Providers
- Credential
- D.D.S.
- Sex
- Male
- Sole proprietor
- Yes
- License
- 1318 (OK)
Specialties & taxonomies
Dental Providers
Dental Providers
Practice location
429 Nw 11th St
Apt 6
Oklahoma City, OK 73103-3927
Phone: (734) 604-1843
Approximate (ZIP-level) locationGet directions
Mailing address
1942 Sherman St Se
Grand Rapids, MI 49506-2918
Registry dates
- Enumerated
- 2015-11-19
- Last updated
- 2021-12-08
- Certified
- 2021-12-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.