OrganizationActive
Dental Depot of Broken Arrow, PLLC
NPI 1780001636 · Dentist · Broken Arrow, OK
Provider details
- NPI number
- 1780001636
- Entity type
- Organization
- Primary specialty
- DentistDental Providers
- Organization subpart
- No
- Authorized official
- Glenn Ashmore, Owner / President(405) 949-0123
- License
- 3723 (OK)
Specialties & taxonomies
Dental Providers
Profile Score
Detailed profile(76/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
12 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
1950 W Kenosha St
Broken Arrow, OK 74012-8944
Phone: (405) 945-8941
Fax: (405) 945-8959
Street-level locationGet directions
Mailing address
2828 Nw 30th St
Oklahoma City, OK 73112-7404
Registry dates
- Enumerated
- 2014-03-27
- Last updated
- 2021-06-22
- Certified
- 2021-06-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.