Healthcare Provider Details

I. General information

NPI: 1134901358
Provider Name (Legal Business Name): TYSON GALBRAITH DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/23/2023
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12200 N MACARTHUR BLVD STE 1
OKLAHOMA CITY OK
73162-1849
US

IV. Provider business mailing address

18001 AUSTIN CT
EDMOND OK
73012-4600
US

V. Phone/Fax

Practice location:
  • Phone: 405-656-7067
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number8167
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: