Healthcare Provider Details

I. General information

NPI: 1992623169
Provider Name (Legal Business Name): SAXON PERIODONTICS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6143 E 91ST ST
TULSA OK
74137-3104
US

IV. Provider business mailing address

6143 E 91ST ST
TULSA OK
74137-3104
US

V. Phone/Fax

Practice location:
  • Phone: 918-221-6143
  • Fax:
Mailing address:
  • Phone: 918-221-6143
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number
License Number State

VIII. Authorized Official

Name: DR. MATTHEW SAXON
Title or Position: OWNER
Credential: DDS
Phone: 816-651-9683