Provider Demographics
NPI:1811303274
Name:AL SALAYTA, MUHANNAD SHEBLI (DDS)
Entity type:Individual
Prefix:DR
First Name:MUHANNAD
Middle Name:SHEBLI
Last Name:AL SALAYTA
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 1:7334 S SLEEPY HOLLOW DR
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-5917
Mailing Address - Country:US
Mailing Address - Phone:512-769-1776
Mailing Address - Fax:
Practice Address - Street 1:9404 S ELWOOD AVE
Practice Address - Street 2:
Practice Address - City:JENKS
Practice Address - State:OK
Practice Address - Zip Code:74037-2317
Practice Address - Country:US
Practice Address - Phone:918-299-2298
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-07
Last Update Date:2025-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK6652122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist