Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Custom Dental of Edmond, PLLC

Organization General Practice Dentistry · NPI 1013211846

Custom Dental of Edmond, PLLC provides General Practice Dentistry in Oklahoma City, Oklahoma. Licensed in Oklahoma. Registered with an NPI since 2011.

Licensed in
OK
In the registry since
2011
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

17840 N Penn
Oklahoma City, OK 73012 Not confirmed with CMS for 15 years — call before visiting
Phone: (405) 282-6440
Fax: (405) 282-6785
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X · Licence 5978 (OK)

Record details

NPI number1013211846
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Grant Pitt — Dentist · (405) 282-6440
NPI enumeratedJanuary 10, 2011
Last updated in NPPESSeptember 15, 2011
Mailing address17840 N Pennsylvania Ave, Edmond, OK 73012-9097

Other providers in Oklahoma City