Healthcare Provider Details

I. General information

NPI: 1427856459
Provider Name (Legal Business Name): DEKOTA APPLETON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/05/2025
Last Update Date: 03/05/2025
Certification Date: 03/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 PLAZA RM 305
MADILL OK
73446-2273
US

IV. Provider business mailing address

1105 E CRUMP ST
WYNNEWOOD OK
73098-2037
US

V. Phone/Fax

Practice location:
  • Phone: 580-257-2002
  • Fax:
Mailing address:
  • Phone: 405-444-1472
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: