MEDICARE: PEDIATRIC DENTISTRY OF TULSA P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223P0221X	Pediatric Dentistry	3620	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	013754	OTHER	OK	UNITED CONCORDIA
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457518961
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PEDIATRIC DENTISTRY OF TULSA P.C.

Provider Business Mailing Address
First Line	:	5602 S MEMORIAL DR
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74145-9016
Country	:	US
Telephone Number	:	918-664-9797
Fax Number	:	918-664-1666

Provider Business Practice Location Address
First Line	:	5602 S MEMORIAL DR
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74145-9016
Country	:	US
Telephone Number	:	918-664-9797
Fax Number	:	918-664-1666

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. RONALD LYNN WINDER
Credential	:	D.D.S.
Telephone Number	:	918-664-9797

Provider Enumeration Date	:	05/21/2008
Last Update Date	:	05/21/2008

Similar Medicare Providers

1376542928 — DR. RONALD LYNN WINDER D.D.S.
Practice Location Address:

5602 S MEMORIAL DR
TULSA, OK
74145-9016

Practice Phone: 918-664-9797
Practice Fax: 918-664-1666

1992711881 — DR. DENNIS EDWARD SMITH II D.D.S.
Practice Location Address:

5620 S MEMORIAL DR
TULSA, OK
74145-9016

Practice Phone: 918-664-8156
Practice Fax: 918-664-6344

1619147816 — DENNIS E SMITH DDS PC
Practice Location Address:

5620 S MEMORIAL DR
TULSA, OK
74145-9016

Practice Phone: 918-664-8156
Practice Fax: 918-664-6344

1508736869 — DANIEL DONALDSON PTA
Practice Location Address:

9016 S FULTON AVE
TULSA, OK
74137-3589

Practice Phone: 918-313-1242
Practice Fax:

1194676742 — ANDREA LOCKTON LPN
Practice Location Address:

3445 S SHERIDAN RD
TULSA, OK
74145-1105

Practice Phone: 918-610-3366
Practice Fax: 918-610-3344

1861145153 — SAMIRA YOUSEF LPC
Practice Location Address:

4845 S SHERIDAN RD STE 509
TULSA, OK
74145-5719

Practice Phone: 405-208-4469
Practice Fax: 405-208-4472

Directions to “PEDIATRIC DENTISTRY OF TULSA P.C. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.