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OKLAHOMA AESTHETIC RECONSTRUCTIVE SURGERY LLC
NPI 1932879699
Surgery - Plastic and Reconstructive Surgery in Oklahoma City, OK

Active since September 15, 2021
13820 WIRELESS WAY, OKLAHOMA CITY, OK 73134(405) 246-0391(405) 246-0392 Get Directions Write a Review

NPPES record last updated: October 29, 2021. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Oklahoma Aesthetic Reconstructive Surgery Llc NPPES

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

OKLAHOMA AESTHETIC RECONSTRUCTIVE SURGERY LLC (NPI 1932879699) is a healthcare organization registered as a plastic and reconstructive surgery in Oklahoma City, Oklahoma and active in the NPI registry since September 2021. The organization lists Stacey Dill, Office Administrator, as its authorized official.

NPPES Registry Identity

NPI1932879699
Entity TypeOrganization
Primary Taxonomy2086S0122X
Legal Business NameOKLAHOMA AESTHETIC RECONSTRUCTIVE SURGERY LLC
Location Address13820 WIRELESS WAYOklahoma City, OK 73134-2501
Mailing Address2708 W Country Club DrOklahoma City, OK 73116-4219 · (405) 246-0391 · Fax (405) 246-0392
Phone(405) 246-0391
Fax(405) 246-0392
Organization SubpartNo
Authorized OfficialStacey DillOffice Administrator · (405) 735-9700
Enumeration DateSeptember 15, 2021
Last NPPES UpdateOctober 29, 2021
NPPES CertifiedOctober 29, 2021
✔ NPI 1932879699 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgery · Plastic and Reconstructive SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code2086S0122X
Definition

A surgeon who specializes in plastic and reconstructive surgery.

13820 WIRELESS WAY, Oklahoma City, OK 73134
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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

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 37D2285923

Oklahoma Aesthetics Surgery Center · Oklahoma City, OK
Active · expires Jul 19, 2027
CLIA Number37D2285923
Laboratory TypeAmbulatory Surgery Center
Certificate Effective DateJuly 20, 2025
Certificate Expiration DateJuly 19, 2027
Laboratory DirectorDerek Shadid
Laboratory Phone(405) 755-4451
Laboratory LocationOklahoma Aesthetics Surgery Center7316 N Classen Blvd, Oklahoma City, OK 73116
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 4

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

DR. BETSY ANN SHADID M.D.
Psychiatry & Neurology (Child & Adolescent Psychiatry)
13820 WIRELESS WAY
OKLAHOMA CITY, OK 73134
Oklahoma County (405) 471-4047
O.V.S., P.L.L.C.
Phlebology
13820 WIRELESS WAY
OKLAHOMA CITY, OK 73134
Oklahoma County (405) 947-8346
SHADID PLASTIC SURGERY ASSOCIATES
Specialist
13820 WIRELESS WAY
OKLAHOMA CITY, OK 73134
Oklahoma County (405) 755-4451
BETSY SHADID M.D., PLLC
Psychiatry & Neurology (Psychiatry)
13820 WIRELESS WAY
OKLAHOMA CITY, OK 73134
Oklahoma County (405) 471-4047

Frequently Asked Questions

What is OKLAHOMA AESTHETIC RECONSTRUCTIVE SURGERY LLC's NPI number?

The NPI number assigned to this healthcare provider is 1932879699, enumerated as an "organization" on September 15, 2021.

Where is the provider located?

The provider is located at 13820 WIRELESS WAY OKLAHOMA CITY, OK 73134 and the phone number is (405) 246-0391.

What is the provider's specialty?

Surgery with taxonomy code 2086S0122X and a focus in Plastic and Reconstructive Surgery.