Elite Oral and Maxillofacial Surgery of Oklahoma City, PLLC

Primary specialty

Public Health DentistryTaxonomy code 1223D0001X

Legal business name

ELITE ORAL AND MAXILLOFACIAL SURGERY OF OKLAHOMA CITY, PLLC

Practice address

340 W Vandament Ave
Yukon, OK 73099-4640

Phone

(918) 998-0996

NPI assigned

Jan 7, 2025

Last updated

Jan 7, 2025By 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

Creed Cardon

Title

Owner/Dentist

Phone

(918) 998-0996

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1736208000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736208000000",
    "number": "1174333744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 RIVERWALK TER STE 250",
            "city": "JENKS",
            "state": "OK",
            "postal_code": "740375619",
            "telephone_number": "918-998-0996",
            "fax_number": "918-235-9079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 W VANDAMENT AVE",
            "city": "YUKON",
            "state": "OK",
            "postal_code": "730994640",
            "telephone_number": "918-998-0996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE ORAL AND MAXILLOFACIAL SURGERY OF OKLAHOMA CITY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-07",
        "last_updated": "2025-01-07",
        "certification_date": "2025-01-07",
        "status": "A",
        "authorized_official_last_name": "CARDON",
        "authorized_official_first_name": "CREED",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "918-998-0996"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Public Health Dentistry in Yukon, OK
• Providers in Yukon, OK by specialty
• Public Health Dentistry in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2025; 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.