Kimiko and Tedesco LLC
NPI 1396497319 · Procedural Dermatology Physician · Tulsa, OK
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Kimiko and Tedesco LLC is a Procedural Dermatology Physician organization in Tulsa, OK (NPI 1396497319).
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
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
4 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
Mailing address
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
Frequently asked questions
- What is Kimiko and Tedesco LLC's NPI number?
- Kimiko and Tedesco LLC's National Provider Identifier (NPI) is 1396497319, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Kimiko and Tedesco LLC?
- Kimiko and Tedesco LLC is classified in the NPPES registry as Procedural Dermatology Physician (Allopathic & Osteopathic Physicians).
- Where is Kimiko and Tedesco LLC located?
- Kimiko and Tedesco LLC's practice location on file with NPPES is 11911 S Oxford Ave Ste 200, Tulsa, OK 74137-7778.
- What is Kimiko and Tedesco LLC's phone number?
- The practice phone number listed in the NPPES registry for Kimiko and Tedesco LLC is (918) 600-0026.
- Does Kimiko and Tedesco LLC accept Medicare?
- Kimiko and Tedesco LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Kimiko and Tedesco LLC?
- The authorized official listed on Kimiko and Tedesco LLC's NPPES record is Breann Tedesco, Office Manager. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Kimiko and Tedesco LLC's NPI active?
- Yes — Kimiko and Tedesco LLC's NPI (1396497319) is active in the NPPES registry as of the last update on 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.