Healthcare Provider Details

I. General information

NPI: 1760316210
Provider Name (Legal Business Name): KAIROS PRONOIA, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

340 S SANTA FE AVE
EDMOND OK
73003-6328
US

IV. Provider business mailing address

340 S SANTA FE AVE
EDMOND OK
73003-6328
US

V. Phone/Fax

Practice location:
  • Phone: 405-348-7775
  • Fax: 405-348-8010
Mailing address:
  • Phone: 405-348-7775
  • Fax: 405-348-8010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. KELLI PRESCOTT
Title or Position: DENTIST
Credential: DMD
Phone: 405-348-7775