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DENTAL DEPOT OF 63RD & NW EXPRESSWAY, PLLC
NPI 1861058877
Clinic/Center - Dental in Oklahoma City, OK

Active since May 15, 2019
4025 NW 63RD STREET, OKLAHOMA CITY, OK 73116(405) 591-3123(405) 653-1714 Get Directions Write a Review

NPPES record last updated: June 25, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 25, 2021, May 15, 2019 (2 updates tracked since 2019).

About Dental Depot Of 63rd & Nw Expressway, Pllc NPPES

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

DENTAL DEPOT OF 63RD & NW EXPRESSWAY, PLLC (NPI 1861058877) is a healthcare organization registered as a dental in Oklahoma City, Oklahoma and active in the NPI registry since May 2019. The organization lists Glenn Allan Ashmore, Owner / President, as its authorized official.

NPPES Registry Identity

NPI1861058877
Entity TypeOrganization
Primary Taxonomy261QD0000X
Legal Business NameDENTAL DEPOT OF 63RD & NW EXPRESSWAY, PLLC
Location Address4025 NW 63RD STREETOklahoma City, OK 73116
Mailing Address2828 Nw 30th StOklahoma City, OK 73112-7404 · (405) 591-3123 · Fax (405) 653-1714
Phone(405) 591-3123
Fax(405) 653-1714
Organization SubpartNo
Authorized OfficialGlenn Allan AshmoreOwner / President · (405) 591-3123
Enumeration DateMay 15, 2019
Last NPPES UpdateJune 25, 20212 updates tracked since enumeration
NPPES CertifiedJune 25, 2021
✔ NPI 1861058877 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · DentalAmbulatory Health Care Facilities
Taxonomy Code261QD0000X
4025 NW 63RD STREET, Oklahoma City, OK 73116
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Other Identifiers 1

Medicaid100088170AOK

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include UnitedHealthcare.Insurance ›

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 Dental Depot Of 63rd & NW Expressway, PLLC's NPI number?

The NPI number for Dental Depot Of 63rd & NW Expressway, PLLC is 1861058877. It was assigned to this organization in the NPPES registry on May 15, 2019.

Where is Dental Depot Of 63rd & NW Expressway, PLLC located?

Dental Depot Of 63rd & NW Expressway, PLLC is located at 4025 NW 63rd Street, Oklahoma City, OK 73116. The listed phone number is (405) 591-3123.

What is Dental Depot Of 63rd & NW Expressway, PLLC's specialty?

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

What insurance does Dental Depot Of 63rd & NW Expressway, PLLC accept?

Health plans from UnitedHealthcare list Dental Depot Of 63rd & NW Expressway, PLLC 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 Dental Depot Of 63rd & NW Expressway, PLLC was last updated on June 25, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.