Healthcare Provider Details

I. General information

NPI: 1194106013
Provider Name (Legal Business Name): PERKINS DENTAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2015
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 E HIGHWAY 33
PERKINS OK
74059-4413
US

IV. Provider business mailing address

1900 NW EXPRESSWAY STE 1600
OKLAHOMA CITY OK
73118-1839
US

V. Phone/Fax

Practice location:
  • Phone: 405-708-6644
  • Fax: 405-421-0744
Mailing address:
  • Phone: 405-474-6362
  • Fax: 405-421-0744

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number6256
License Number StateOK

VIII. Authorized Official

Name: JOSHUA V BRASHER
Title or Position: OWNER
Credential: DDS
Phone: 405-474-6362