Healthcare Provider Details

I. General information

NPI: 1992634653
Provider Name (Legal Business Name): JORMI D GARCIA TOMAW
Entity Type: Individual
Gender: Female
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

515 S BROADWAY
EDMOND OK
73034-3851
US

IV. Provider business mailing address

505 E SHERIDAN AVE APT 1302
OKLAHOMA CITY OK
73104-6708
US

V. Phone/Fax

Practice location:
  • Phone: 405-294-4901
  • Fax:
Mailing address:
  • Phone: 813-419-8902
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number8198
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: