1. Home
  2. Directory
  3. Oklahoma
  4. Edmond
  5. Clinic Center
  6. NPI Profile

RONISHA DURHAM DDS PLLC
NPI 1396458857
Clinic/Center - Dental in Edmond, OK

Active since December 29, 2022
15260 LLEYTONS CT, EDMOND, OK 73013(405) 492-7862 Get Directions Write a Review

NPPES record last updated: December 29, 2022. Verified against the NPPES registry weekly; last sync: August 30, 2026.

About Ronisha Durham Dds Pllc NPPES

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

RONISHA DURHAM DDS PLLC (NPI 1396458857), doing business as Revive Dental, is a healthcare organization registered as a dental in Edmond, Oklahoma and active in the NPI registry since December 2022. The organization lists Ronisha Durham, Owner/dentist, as its authorized official.

NPPES Registry Identity

NPI1396458857
Entity TypeOrganization
Primary Taxonomy261QD0000X
Legal Business NameRONISHA DURHAM DDS PLLC
Location Address15260 LLEYTONS CTEdmond, OK 73013-7301
Mailing Address2701 N 23rd St Apt 2403Broken Arrow, OK 74014-2171 · (405) 569-2604
Phone(405) 492-7862
Organization SubpartNo
Authorized OfficialRonisha DurhamOwner/dentist · (405) 569-2604
Enumeration DateDecember 29, 2022
NPPES CertifiedDecember 28, 2022
✔ NPI 1396458857 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · DentalAmbulatory Health Care Facilities
Taxonomy Code261QD0000X
15260 LLEYTONS CT, Edmond, OK 73013
Open in Google Maps ↗

Other Names 1

Doing Business AsRevive Dental

Other Identifiers 1

Medicaid200432880AOK

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 Ronisha Durham Dds PLLC's NPI number?

The NPI number for Ronisha Durham Dds PLLC is 1396458857. It was assigned to this organization in the NPPES registry on December 29, 2022. The provider is doing business as Revive Dental.

Where is Ronisha Durham Dds PLLC located?

Ronisha Durham Dds PLLC is located at 15260 Lleytons Ct, Edmond, OK 73013. The listed phone number is (405) 492-7862.

What is Ronisha Durham Dds 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 Ronisha Durham Dds PLLC was last updated on December 29, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.