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CUSTOM DENTAL OF YUKON, PLLC
NPI 1164049185
Clinic/Center - Dental in Yukon, OK

Active since June 26, 2020
4425 GRANT BLVD, YUKON, OK 73099(405) 494-4856(405) 494-4184 Get Directions Write a Review

NPPES record last updated: June 26, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Custom Dental Of Yukon, Pllc NPPES

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

CUSTOM DENTAL OF YUKON, PLLC (NPI 1164049185) is a healthcare organization registered as a dental in Yukon, Oklahoma and active in the NPI registry since June 2020. The organization lists Katelyn Johnson, Owner-doctor, as its authorized official.

NPPES Registry Identity

NPI1164049185
Entity TypeOrganization
Primary Taxonomy261QD0000X
Legal Business NameCUSTOM DENTAL OF YUKON, PLLC
Location Address4425 GRANT BLVDYukon, OK 73099
Mailing Address4425 Grant BlvdYukon, OK 73099 · (405) 494-4856 · Fax (405) 494-4184
Phone(405) 494-4856
Fax(405) 494-4184
Organization SubpartNo
Authorized OfficialKatelyn JohnsonOwner-doctor · (918) 839-9088
Enumeration DateJune 26, 2020
NPPES CertifiedJune 26, 2020
✔ NPI 1164049185 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · DentalAmbulatory Health Care Facilities
Taxonomy Code261QD0000X
4425 GRANT BLVD, Yukon, OK 73099
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Custom Dental Of Yukon, PLLC's NPI number?

The NPI number for Custom Dental Of Yukon, PLLC is 1164049185. It was assigned to this organization in the NPPES registry on June 26, 2020.

Where is Custom Dental Of Yukon, PLLC located?

Custom Dental Of Yukon, PLLC is located at 4425 Grant Blvd, Yukon, OK 73099. The listed phone number is (405) 494-4856.

What is Custom Dental Of Yukon, PLLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Dental, with taxonomy code 261QD0000X.

When was this NPI record last updated?

The NPPES record for Custom Dental Of Yukon, PLLC was last updated on June 26, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.