Healthcare Provider Details

I. General information

NPI: 1881542280
Provider Name (Legal Business Name): SHANNON ELIZABETH SCHMIDT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2026
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2323 N MACARTHUR BLVD
OKLAHOMA CITY OK
73127-2207
US

IV. Provider business mailing address

2234 S SALCEDO ST
NEW ORLEANS LA
70125-4452
US

V. Phone/Fax

Practice location:
  • Phone: 405-601-0043
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number8250
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: