DENTAL DEPOT 62ND & SOUTH WESTERN PLLC
NPI 1003196239
Dentist - General Practice in Oklahoma City, OK

Q: What is Dental Depot 62nd & South Western PLLC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Active since August 19, 2011

6217 S WESTERN AVE, OKLAHOMA CITY, OK 73139(405) 606-7123(405) 606-7130 Get Directions Write a Review

NPPES record last updated: June 25, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Dental Depot 62nd & South Western Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DENTAL DEPOT 62ND & SOUTH WESTERN PLLC (NPI 1003196239) is a healthcare organization registered as a general practice in Oklahoma City, Oklahoma and active in the NPI registry since August 2011. The organization lists Glenn Allen Ashmore, President, as its authorized official.

NPPES Registry Identity

NPI1003196239

Entity TypeOrganization

Primary Taxonomy1223G0001X

Legal Business NameDENTAL DEPOT 62ND & SOUTH WESTERN PLLC

Location Address6217 S WESTERN AVEOklahoma City, OK 73139-1605

Mailing Address2828 Nw 30th StOklahoma City, OK 73112-7404 · (405) 606-7123 · Fax (405) 606-7130

Phone(405) 606-7123

Fax(405) 606-7130

Organization SubpartNo

Authorized OfficialGlenn Allen AshmorePresident · (405) 949-0123

Enumeration DateAugust 19, 2011

Last NPPES UpdateJune 25, 2021

NPPES CertifiedJune 25, 2021

✔ NPI 1003196239 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers

Taxonomy Code1223G0001X

Definition

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

6217 S WESTERN AVE, Oklahoma City, OK 73139

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Sunflower Health Plan and more.Insurance ›

Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ERIC H LEE DDS

Clinic/Center (Dental)