Healthcare Provider Details

I. General information

NPI: 1043748494
Provider Name (Legal Business Name): TOBY D ALLEN DDS, PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/30/2017
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 S PEORIA AVE
TULSA OK
74120-3820
US

IV. Provider business mailing address

530 S PEORIA AVENUE
TULSA OK
74120-3820
US

V. Phone/Fax

Practice location:
  • Phone: 918-588-1900
  • Fax: 918-382-1285
Mailing address:
  • Phone: 405-255-6216
  • Fax: 918-382-1285

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number6959
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: