NPIMap

Organization Active NPI

Serenity Dental

  • Dental Clinic/Center
  • Edmond, OK
National Provider Identifier
1649104837
Registry record updated Jul 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
SERENITY DENTAL
Practice address
825 Kelly Lakes Pass
Edmond, OK 73025-9271
Phone
(405) 861-8671
NPI assigned
Jun 11, 2026
Last updated
Jul 14, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2026

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

Authorized official

Name
Dr. Abigail Poulan, DDSNPI 1194619858
Title
Dentist
Phone
(405) 308-9447

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X NU Primary

Addresses

Primary practice location

825 Kelly Lakes Pass
Edmond, OK 73025-9271

Mailing address

825 Kelly Lakes Pass
Edmond, OK 73025-9271

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1781136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783987200000",
    "number": "1649104837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 KELLY LAKES PASS",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730259271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 KELLY LAKES PASS",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730259271",
            "telephone_number": "405-861-8671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-06-11",
        "last_updated": "2026-07-14",
        "certification_date": "2026-07-14",
        "status": "A",
        "authorized_official_last_name": "POULAN",
        "authorized_official_first_name": "ABIGAIL",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "405-308-9447",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmond, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 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.