KIMIKO AND TEDESCO LLC
NPI 1396497319
Dermatology - Procedural Dermatology in Tulsa, OK

Q: What is Kimiko And Tedesco LLC's NPI number?

The NPI number for Kimiko And Tedesco LLC is 1396497319. It was assigned to this organization in the NPPES registry on January 20, 2022. The provider is doing business as Green Country Surgical Arts. The provider was formerly known as Kimiko Medical Aesthetics.

Q: What is Kimiko And Tedesco LLC's specialty?

The primary specialty registered for this NPI is Dermatology, specializing in Procedural Dermatology, with taxonomy code 207NS0135X.

Active since January 20, 2022

11911 S OXFORD AVE STE 200, TULSA, OK 74137(918) 600-0026(918) 600-0690 Get Directions Write a Review

NPPES record last updated: September 9, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 9, 2025, Feb 2, 2023, Sep 16, 2022 and 1 more (4 updates tracked since 2022).

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About Kimiko And Tedesco Llc NPPES

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

KIMIKO AND TEDESCO LLC (NPI 1396497319), doing business as Green Country Surgical Arts, is a healthcare organization registered as a procedural dermatology in Tulsa, Oklahoma and active in the NPI registry since January 2022. The organization lists Breann H Tedesco, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1396497319

Entity TypeOrganization

Primary Taxonomy207NS0135X

Legal Business NameKIMIKO AND TEDESCO LLC

Location Address11911 S OXFORD AVE STE 200Tulsa, OK 74137-7778

Mailing Address11911 S Oxford Ave Ste 200Tulsa, OK 74137-7778 · (918) 600-0026 · Fax (918) 600-0690

Phone(918) 600-0026

Fax(918) 600-0690

Organization SubpartNo

Authorized OfficialBreann H TedescoOffice Manager · (918) 600-0026

Enumeration DateJanuary 20, 2022

Last NPPES UpdateSeptember 9, 20254 updates tracked since enumeration

NPPES CertifiedSeptember 9, 2025

✔ NPI 1396497319 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyDermatology · Procedural DermatologyAllopathic & Osteopathic Physicians

Taxonomy Code207NS0135X

Definition

Procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery, chemical surgery, cryosurgery (liquid nitrogen), electrosurgery, aspiration surgery, liposuction, injection of filler substances, and Mohs micrographic controlled surgery (a special technique for the removal of growths, especially skin cancers).

Also ListedPlastic Surgery · Plastic Surgery Within the Head and NeckTaxonomy 2082S0099X

Also ListedSurgery · Plastic and Reconstructive SurgeryTaxonomy 2086S0122X

11911 S OXFORD AVE STE 200, Tulsa, OK 74137

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Other Names 2

Doing Business AsGreen Country Surgical Arts

Former Legal Business NameKimiko Medical Aesthetics

Other Identifiers 11

Other1790951747OK · Community Care

Medicaid1790951747OK

Other1790951747OK · Phcs

Other1790951747OK · Aetna

Other1790951747OK · Va

Other1790951747OK · Cigna

Other1790951747OK · United Healthcare

Other1790951747OK · Blue Cross Blue Shield

Other1790951747OK · Prefered Community Choice

Other1790951747OK · Global Health

Other1790951747OK · Health Choice

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Oklahoma.Insurance ›

Other Providers at the Same Location NPPES 2

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

JOHN VICTOR TEDESCO D.O.

Surgery (Plastic and Reconstructive Surgery)

11911 S OXFORD AVE STE 200
TULSA, OK 74137

Tulsa County (918) 984-5063

CLOVER PEDIATRIC WELLNESS AND WEIGHT MANAGEMENT

Pediatrics (Pediatric Endocrinology)

11911 S OXFORD AVE STE 200
TULSA, OK 74137

Tulsa County (918) 884-6623

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 Kimiko And Tedesco LLC's NPI number?

The NPI number for Kimiko And Tedesco LLC is 1396497319. It was assigned to this organization in the NPPES registry on January 20, 2022. The provider is doing business as Green Country Surgical Arts. The provider was formerly known as Kimiko Medical Aesthetics.

Where is Kimiko And Tedesco LLC located?

Kimiko And Tedesco LLC is located at 11911 S Oxford Ave Ste 200, Tulsa, OK 74137. The listed phone number is (918) 600-0026.

What is Kimiko And Tedesco LLC's specialty?

The primary specialty registered for this NPI is Dermatology, specializing in Procedural Dermatology, with taxonomy code 207NS0135X.

What insurance does Kimiko And Tedesco LLC accept?

Health plans from Blue Cross and Blue Shield of Oklahoma list Kimiko And Tedesco LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kimiko And Tedesco LLC was last updated on September 9, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months 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.