Jordan Tyler Blalock, DDS

Individual provider Active NPI General Practice Dentistry · Duncan, OK

NPI 1538098017 · NPPES record last updated May 19, 2026

Key facts

NPI
1538098017
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
8189 (OK)
Practice address
1007 W Oak Ave
Duncan, OK 73533-4537
Phone
(580) 255-6621
Fax
(580) 252-7345
NPI assigned
May 19, 2026
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Oral and Maxillofacial Surgery Associates Oklahoma PC Single Specialty Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry
Group: 193400000X SINGLE SPECIALTY GROUP
1223G0001X 8189 OK Yes

Addresses

Primary practice location

1007 W Oak Ave
Duncan, OK 73533-4537

Mailing address

605 W Choctaw St
Marlow, OK 73055-3239
Phone (580) 467-7180

Other providers in Duncan, OK

All providers in Duncan, OK · General Practice Dentistry in Oklahoma

Sources for this page

Verify at the official NPI Registry.