Pediatric Dental Care, PLLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

PEDIATRIC DENTAL CARE, PLLC

Practice address

1300 Crop Cir
Yukon, OK 73099-4945

Phone

(214) 702-0729

NPI assigned

Jun 17, 2019

Last updated

Jan 28, 2026By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Amanda Lightfoot

Title

Authorized Representative

Phone

(214) 702-0708

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1560729600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769558400000",
    "number": "1033779731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15660 DALLAS PKWY STE 950",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752483309",
            "telephone_number": "214-702-0729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 CROP CIR",
            "city": "YUKON",
            "state": "OK",
            "postal_code": "730994945",
            "telephone_number": "214-702-0729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC DENTAL CARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-17",
        "last_updated": "2026-01-28",
        "certification_date": "2026-01-28",
        "status": "A",
        "authorized_official_last_name": "LIGHTFOOT",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "AUTHORIZED REPRESENTATIVE",
        "authorized_official_telephone_number": "214-702-0708"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bradyn Payne, APRN-CNP
• Jennifer Dawn Payne
• Mandi G Payne, LCSW
• McKinley Haydon Payne, OTR/L
• Jana Pearson, CCC-SLP
• Natalie Michelle Penick
• Allyson Nicole Perez, COTA
• Ana Sophia Perez, RBT
• Stacey Lynn Perez, RN
• Dylan Perkins

• Pediatric Dentistry in Yukon, OK
• Providers in Yukon, OK by specialty
• Pediatric Dentistry in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.