Provider Demographics
NPI:1861422016
Name:OISTER, JANA KAY (DDS)
Entity type:Individual
Prefix:MRS
First Name:JANA
Middle Name:KAY
Last Name:OISTER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1506 S GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:CHEROKEE
Mailing Address - State:OK
Mailing Address - Zip Code:73728-4529
Mailing Address - Country:US
Mailing Address - Phone:580-596-3541
Mailing Address - Fax:
Practice Address - Street 1:204 SOUTHGATE ADDN
Practice Address - Street 2:
Practice Address - City:CHEROKEE
Practice Address - State:OK
Practice Address - Zip Code:73728
Practice Address - Country:US
Practice Address - Phone:580-596-3541
Practice Address - Fax:580-596-3542
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2016-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK5155122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100126180AMedicaid