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

Nicoma Park Dental PLLC

Organization Dental Clinic/Center · NPI 1518452952

Nicoma Park Dental PLLC is a Dental Clinic/Center in Oklahoma City, Oklahoma. Registered with an NPI since 2018.

In the registry since
2018
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

10420 NE 23rd St
Oklahoma City, OK 73141-5216
Phone: (405) 603-8520
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dental Clinic/Center (primary) Taxonomy 261QD0000X

Record details

NPI number1518452952
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jason Wallace — Owner · (405) 413-7466
NPI enumeratedJune 27, 2018
Last updated in NPPESJune 27, 2018
Mailing address3801 N Bryan Ave, Bethany, OK 73008-3001

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