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

Kimiko and Tedesco LLC

Organization Procedural Dermatology Physician · NPI 1396497319

Kimiko and Tedesco LLC is a Procedural Dermatology Physician in Tulsa, Oklahoma. Registered with an NPI since 2022.

In the registry since
2022
Specialties on file
3
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

11911 S Oxford Ave Ste 200
Tulsa, OK 74137-7778
Phone: (918) 600-0026
Fax: (918) 600-0690
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Procedural Dermatology Physician (primary) Taxonomy 207NS0135X
Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician Taxonomy 2082S0099X
Plastic and Reconstructive Surgery Physician Taxonomy 2086S0122X

Record details

NPI number1396497319
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Breann Tedesco — Office Manager · (918) 600-0026
Other names Green Country Surgical Arts; Kimiko Medical Aesthetics
NPI enumeratedJanuary 20, 2022
Last updated in NPPESSeptember 9, 2025
Certification dateSeptember 9, 2025
Mailing address11911 S Oxford Ave Ste 200, Tulsa, OK 74137-7778

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