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General NPI Number Information
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NPI Number | 1841147832
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Entity Type | Organization
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Legal Business Name | SMILING FACES OKC PLLC
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Dates
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Enumeration Date | 03/11/2026
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Last Update Date | 03/11/2026
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Provider Practice Location Address
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Address Line | 5222 N PORTLAND AVE
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City | OKLAHOMA CITY
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State | OK
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Zip | 73112-2070
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Country | US
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Telephone | 405-947-1525
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Fax |
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Provider Business Mailing Address
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Address Line | 5222 N PORTLAND AVE
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City | OKLAHOMA CITY
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State | OK
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Zip | 73112-2070
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Country | US
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Telephone | 405-947-1525
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF PROVIDER RELATIONS
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Name | GAYLON ZISSA
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Credential |
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Telephone | 405-945-8941
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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