Healthcare Provider Details

I. General information

NPI: 1245023399
Provider Name (Legal Business Name): SUNSHINE SMILES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2025
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

427 W STONE WOOD DR STE 427
BROKEN ARROW OK
74012-1026
US

IV. Provider business mailing address

427 W STONEWOOD DR, STE 427
BROKEN ARROW OK
74012
US

V. Phone/Fax

Practice location:
  • Phone: 918-364-2222
  • Fax:
Mailing address:
  • Phone: 918-918-1815
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State

VIII. Authorized Official

Name: MARTIN FREDERICK TROCKEL
Title or Position: OWNER
Credential:
Phone: 801-319-0603