Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dental Depot of Broken Arrow, PLLC

Organization Dentist · NPI 1780001636

Dental Depot of Broken Arrow, PLLC is a Dentist in Broken Arrow, Oklahoma. Licensed in Oklahoma. Registered with an NPI since 2014.

Licensed in
OK
In the registry since
2014
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1950 W Kenosha St
Broken Arrow, OK 74012-8944
Phone: (405) 945-8941
Fax: (405) 945-8959
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence 3723 (OK)

Record details

NPI number1780001636
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Glenn Ashmore — Owner / President · (405) 949-0123
NPI enumeratedMarch 27, 2014
Last updated in NPPESJune 22, 2021
Certification dateJune 22, 2021
Mailing address2828 Nw 30th St, Oklahoma City, OK 73112-7404

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