Organization Active NPI

Kes PLLC

  • Periodontics
  • Edmond, OK
National Provider Identifier
1720815863
Registry record updated Sep 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
Legal business name
KES PLLC
Practice address
609 S. Kelly Ave.
Ste. a-1
Edmond, OK 73003
Phone
(405) 509-8932
Fax
(405) 531-0808
NPI assigned
Sep 13, 2024
Last updated
Sep 13, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2024

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

Authorized official

Name
Dr. Blaire Esteniuk, DDS, MS
Title
Owner/Operator
Phone
(405) 509-8932

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X NU Primary

Addresses

Primary practice location

609 S. Kelly Ave.
Ste. a-1
Edmond, OK 73003

Mailing address

609 S. Kelly Ave.
Ste. a-1
Edmond, OK 73003
Phone (405) 509-8932

National Provider Directory

National Provider Directory

Locations

609 S Kelly Ave
Ste A1
Edmond, OK 73003
Phone (405) 340-3880

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": "1726185600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726185600000",
    "number": "1720815863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "609 S. KELLY AVE.",
            "address_2": "STE. A-1",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "73003",
            "telephone_number": "405-509-8932",
            "fax_number": "405-531-0808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "609 S. KELLY AVE.",
            "address_2": "STE. A-1",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "73003",
            "telephone_number": "405-509-8932",
            "fax_number": "405-531-0808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-13",
        "last_updated": "2024-09-13",
        "status": "A",
        "authorized_official_last_name": "ESTENIUK",
        "authorized_official_first_name": "BLAIRE",
        "authorized_official_title_or_position": "OWNER/OPERATOR",
        "authorized_official_telephone_number": "405-509-8932",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, MS"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "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 Sep 13, 2024; 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.