MEDICARE: PEDIATRIC DENTAL SERVICES OF OKLAHOMA PLLC

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

General Provider Information

NPI Number	:	1619820719
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PEDIATRIC DENTAL SERVICES OF OKLAHOMA PLLC

Provider Business Mailing Address
First Line	:	10157 STONE GATE WAY
Second Line	:
City	:	ARCADIA
State	:	OK
Zip	:	73007-7529
Country	:	US
Telephone Number	:	801-201-8396
Fax Number	:

Provider Business Practice Location Address
First Line	:	550 NE 24TH ST STE H
Second Line	:
City	:	NEWCASTLE
State	:	OK
Zip	:	73065-6364
Country	:	US
Telephone Number	:	801-201-8396
Fax Number	:

Authorized Official
Title or Position	:	MEMBER
Name	:	DR. DAVID EVANS
Credential	:	DMD
Telephone Number	:	801-201-8396

Provider Enumeration Date	:	02/18/2026
Last Update Date	:	03/23/2026

Similar Medicare Providers

1578377610 — OPTIMUM DENTAL OF NEWCASTLE, PLLC
Practice Location Address:

550 NE 24TH ST STE G
NEWCASTLE, OK
73065-6364

Practice Phone: 405-852-2200
Practice Fax: 405-852-2201

1871807172 — DR. DAVID T. EVANS DMD
Practice Location Address:

550 NE 24TH ST STE H
NEWCASTLE, OK
73065-6364

Practice Phone: 801-201-8396
Practice Fax:

1740283449 — THERAPY IN MOTION PC
Practice Location Address:

2340 NW 32ND ST
NEWCASTLE, OK
73065-6589

Practice Phone: 405-392-3322
Practice Fax: 405-392-3356

1679578959 — RAEANN SUSAN THOMAS PT, MPT
Practice Location Address:

3699 NW 32ND ST
NEWCASTLE, OK
73065-6559

Practice Phone: 405-387-5520
Practice Fax: 405-387-5404

1255330080 — AMANDA LARAE LAWRENCE PT
Practice Location Address:

2340 NW 32ND ST
NEWCASTLE, OK
73065-6589

Practice Phone: 405-396-3322
Practice Fax: 405-392-3356

1821090382 — DR. JENNIFER JOY GRIFFIN D.D.S.
Practice Location Address:

2820 NW 32ND ST
NEWCASTLE, OK
73065-6576

Practice Phone: 405-392-4883
Practice Fax: 405-392-4883

Directions to “PEDIATRIC DENTAL SERVICES OF OKLAHOMA PLLC ” 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.