Healthcare Provider Details

I. General information

NPI: 1396559381
Provider Name (Legal Business Name): DENTAL SPECIALISTS OF OKLAHOMA, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2025
Last Update Date: 02/03/2025
Certification Date: 02/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8301 S WALKER AVE STE 102
OKLAHOMA CITY OK
73139-9416
US

IV. Provider business mailing address

16430 MUIRFIELD PL
EDMOND OK
73013-9161
US

V. Phone/Fax

Practice location:
  • Phone: 405-632-3525
  • Fax:
Mailing address:
  • Phone: 405-696-0908
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number
License Number State

VIII. Authorized Official

Name: DR. YACOUB AL SAKKA
Title or Position: CO-OWNER
Credential: DDS
Phone: 405-510-6853