OrganizationActive
Custom Dental of Yukon, PLLC
NPI 1164049185 · Dental Clinic/Center · Yukon, OK
Custom Dental of Yukon, PLLC is a Dental Clinic/Center organization in Yukon, OK (NPI 1164049185).
Provider details
- NPI number
- 1164049185
- Entity type
- Organization
- Primary specialty
- Dental Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Katelyn Johnson, Owner-Doctor(918) 839-9088
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Established profile(64/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
6 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
4425 Grant Blvd
Yukon, OK 73099
Phone: (405) 494-4856
Fax: (405) 494-4184
Approximate (ZIP-level) locationGet directions
Mailing address
4425 Grant Blvd
Yukon, OK 73099
Registry dates
- Enumerated
- 2020-06-26
- Last updated
- 2020-06-26
- Certified
- 2020-06-26
Frequently asked questions
- What is Custom Dental of Yukon, PLLC's NPI number?
- Custom Dental of Yukon, PLLC's National Provider Identifier (NPI) is 1164049185, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Custom Dental of Yukon, PLLC?
- Custom Dental of Yukon, PLLC is classified in the NPPES registry as Dental Clinic/Center (Ambulatory Health Care Facilities).
- Where is Custom Dental of Yukon, PLLC located?
- Custom Dental of Yukon, PLLC's practice location on file with NPPES is 4425 Grant Blvd, Yukon, OK 73099.
- What is Custom Dental of Yukon, PLLC's phone number?
- The practice phone number listed in the NPPES registry for Custom Dental of Yukon, PLLC is (405) 494-4856.
- Who is the authorized official for Custom Dental of Yukon, PLLC?
- The authorized official listed on Custom Dental of Yukon, PLLC's NPPES record is Katelyn Johnson, Owner-Doctor. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Custom Dental of Yukon, PLLC's NPI active?
- Yes — Custom Dental of Yukon, PLLC's NPI (1164049185) is active in the NPPES registry as of the last update on 2020-06-26.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.