OrganizationActive
Kimiko and Tedesco LLC
NPI 1396497319 · Procedural Dermatology Physician · Tulsa, OK
Provider details
- NPI number
- 1396497319
- Entity type
- Organization
- Primary specialty
- Procedural Dermatology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Breann Tedesco, Office Manager(918) 600-0026
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Practice location
11911 S Oxford Ave Ste 200
Tulsa, OK 74137-7778
Phone: (918) 600-0026
Fax: (918) 600-0690
Approximate (ZIP-level) locationGet directions
Mailing address
11911 S Oxford Ave Ste 200
Tulsa, OK 74137-7778
Other names (DBA / former)
- Doing business as
- Green Country Surgical Arts
- Former legal business name
- Kimiko Medical Aesthetics
Registry dates
- Enumerated
- 2022-01-20
- Last updated
- 2025-09-09
- Certified
- 2025-09-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.