Provider Demographics
NPI:1487100970
Name:OK, SALLY HARIM (DDS, MPH)
Entity type:Individual
Prefix:DR
First Name:SALLY
Middle Name:HARIM
Last Name:OK
Suffix:
Gender:F
Credentials:DDS, MPH
Other - Prefix:DR
Other - First Name:HAH
Other - Middle Name:RHIM
Other - Last Name:OK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:3006 PEPPERCORN DR
Mailing Address - Street 2:
Mailing Address - City:EULESS
Mailing Address - State:TX
Mailing Address - Zip Code:76039-4140
Mailing Address - Country:US
Mailing Address - Phone:817-564-2505
Mailing Address - Fax:
Practice Address - Street 1:3006 PEPPERCORN DR
Practice Address - Street 2:
Practice Address - City:EULESS
Practice Address - State:TX
Practice Address - Zip Code:76039-4140
Practice Address - Country:US
Practice Address - Phone:817-564-2505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-25
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX322681223G0001X, 1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty
No1223G0001XDental ProvidersDentistGeneral Practice