MEDICARE: DR. AYRIKA EIDSON DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	7871	OK

General Provider Information

NPI Number	:	1154162832
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AYRIKA EIDSON DDS

Provider Business Mailing Address
First Line	:	14729 ASHORE DR
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73142-7861
Country	:	US
Telephone Number	:	405-517-3258
Fax Number	:

Provider Business Practice Location Address
First Line	:	981 N SANTA FE AVE
Second Line	:
City	:	EDMOND
State	:	OK
Zip	:	73003-4337
Country	:	US
Telephone Number	:	405-562-6606
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/05/2024
Last Update Date	:	05/18/2026

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