Aesthetic Institute of Oklahoma PLLC

Key facts

NPI

1972487254

Entity type

Organization (NPI type 2)

Primary specialty

Facial Plastic Surgery Physician 207YS0123X

Legal business name

AESTHETIC INSTITUTE OF OKLAHOMA PLLC

Practice address

4509 Integris Pkwy Ste 350
Edmond, OK 73034-8696

Phone

(405) 534-4358

Fax

(405) 657-3896

NPI assigned

Aug 1, 2025

Organization subpart

No

Authorized official

Name

Scott Shadfar, MD NPI 1710148283

Title

Owner

Phone

(405) 834-3275

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

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Scott Shadfar, MD Facial Plastic Surgery Physician · Oklahoma City, OK · NPI 1710148283
  Medicare reassignment NPD Authorized official FACIAL PLASTIC SURGERY · OK

Medicare participation

Medicare fee-for-service enrollment

Enrolled in OK

Medicare enrollment records

National Provider Directory

Specialties & licenses

Addresses

Other names

• Shadfar Facial Plastic Surgery Doing business as

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 1, 2025.

{
    "created_epoch": "1754006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754006400000",
    "number": "1972487254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 797",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731010797",
            "telephone_number": "405-534-4358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4509 INTEGRIS PKWY STE 350",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730348696",
            "telephone_number": "405-534-4358",
            "fax_number": "405-657-3896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AESTHETIC INSTITUTE OF OKLAHOMA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-01",
        "last_updated": "2025-08-01",
        "certification_date": "2025-07-31",
        "status": "A",
        "authorized_official_last_name": "SHADFAR",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "405-834-3275",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207YS0123X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shadfar Facial Plastic Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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All providers in Edmond, OK · Facial Plastic Surgery Physician in Oklahoma