Provider Demographics
NPI:1730618760
Name:RAY, CHRISTOPHER KEVIN (DDS)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:KEVIN
Last Name:RAY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4716 W URBANA ST
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74012-6162
Mailing Address - Country:US
Mailing Address - Phone:918-449-5800
Mailing Address - Fax:918-455-8958
Practice Address - Street 1:4716 W URBANA ST
Practice Address - Street 2:
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74012-6162
Practice Address - Country:US
Practice Address - Phone:918-449-5800
Practice Address - Fax:918-455-8958
Is Sole Proprietor?:No
Enumeration Date:2017-06-04
Last Update Date:2021-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04420002931223S0112X, 204E00000X, 390200000X
OK6915122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program