Dixieland Dental, Inc is a Dental Clinic in Oklahoma City, Oklahoma. It is located at 4117 Nw 122nd St, Suite C, Oklahoma City, OK and its contact number is 405-751-4466. The authorized person for Dixieland Dental, Inc is Katy Shapard
who is Office Manager of the clinic and their contact number is 405-751-4466. The primary license number for Dixieland Dental, Inc is 5733 (General Practice) in Oklahoma.
Dixieland Dental, Inc Clinic caters to patients of all ages for their dental care needs. Dentists at the clinic are responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
Complete Clinic Profile:
Dixieland Dental, Inc Clinic speciality, address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointments.
| Name: | Dixieland Dental, Inc |
| Specialization: | General Practice Dentistry |
| Clinic Address: | 4117 Nw 122nd St, Suite C, Oklahoma City,
Oklahoma, 73120-8869 |
| Phone: | 405-751-4466 |
| Fax: | 405-608-0163 |
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints for this clinic are as below. Person's position and contact details are also mentioned below.
| Name: | Katy Shapard |
| Position: | Office Manager |
| Contact Number: | 405-751-4466 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details for Dixieland Dental, Inc clinic are as mentioned below.
| NPI Number: | 1932360765 |
| NPI Enumeration Date: | 24 Jun, 2008 |
| NPI Last Update On: | 24 Jun, 2008 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Dixieland Dental, Inc are as mentioned below.
| Specialization | License Number | State | Status | |
| General Practice | 5733 | Oklahoma | Primary | |
Other Medical Identifiers:
Other legacy medical identifiers of the clinic such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 200068560A | Medicaid | Oklahoma | |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | Dixieland Dental, Inc
4117 Nw 122nd St,
Oklahoma City, Oklahoma |
| Zip: | 73120-8869 |
| Phone Number: | 405-751-4466 |
| Fax Number: | 405-608-0163 |
Patients can reach Dixieland Dental, Inc at
4117 Nw 122nd St, Suite C, Oklahoma City, Oklahoma or can
call to book an appointment on 405-751-4466.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on
08 December, 2025.