Healthcare Provider Details

I. General information

NPI: 1821927492
Provider Name (Legal Business Name): BLAKE ADAMS DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6540 E 121ST ST S
BIXBY OK
74008-2688
US

IV. Provider business mailing address

6540 E 121ST ST S
BIXBY OK
74008-2688
US

V. Phone/Fax

Practice location:
  • Phone: 918-740-6222
  • Fax:
Mailing address:
  • Phone: 918-740-6222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number8183
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: