MEDICARE: EASY DENTAL DEL CITY PLLC

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

General Provider Information

NPI Number	:	1699312447
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EASY DENTAL DEL CITY PLLC

Provider Business Mailing Address
First Line	:	2500 S BROADWAY STE 350
Second Line	:
City	:	EDMOND
State	:	OK
Zip	:	73013-4040
Country	:	US
Telephone Number	:	918-786-0017
Fax Number	:

Provider Business Practice Location Address
First Line	:	4320 S SUNNYLANE RD
Second Line	:
City	:	DEL CITY
State	:	OK
Zip	:	73115-3742
Country	:	US
Telephone Number	:	405-670-3800
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JOSHUA BRASHER
Credential	:	DDS
Telephone Number	:	405-474-6362

Provider Enumeration Date	:	11/27/2019
Last Update Date	:	07/21/2025

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