IndividualActive
Preston Banoub, DMD
NPI 1578138376 · Oral and Maxillofacial Surgery (Dentist) · Ardmore, OK
Provider details
- NPI number
- 1578138376
- Entity type
- Individual
- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)Dental Providers
- Credential
- DMD
- Sex
- Male
- Sole proprietor
- Yes
- License
- 25506 (OK)
Specialties & taxonomies
Dental Providers
Profile Score
Established profile(71/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
5 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
8 documented practice locations
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
2730 12th Ave Nw
Ardmore, OK 73401-1271
Phone: (580) 226-0010
Street-level locationGet directions
Mailing address
6447 Riverdale Ln
Greendale, WI 53129-2853
Additional practice locations (7)
- 65 Jefferson AveElizabeth, NJ 07201-2474Phone: (908) 367-7712
- 66 Somme StNewark, NJ 07105-3612Phone: (973) 221-2567
- 1758 Nw 82nd StLawton, OK 73505-2356Phone: (580) 354-7223
- 1683 24th Ave NwNorman, OK 73069-6566Phone: (405) 253-2253
- 2123 W Memorial RdOklahoma City, OK 73134-8013Phone: (405) 415-1420
- 6400 Sw 3rd St Ste BOklahoma City, OK 73128-2209Phone: (405) 416-2357
- 2307 N Perkins RdStillwater, OK 74075-2234Phone: (405) 780-4544
Registry dates
- Enumerated
- 2021-05-24
- Last updated
- 2025-06-23
- Certified
- 2025-06-23
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.