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

Dental Depot of Broken Arrow, PLLC

Organization Dentist · NPI 1780001636

Dental Depot of Broken Arrow, PLLC provides Dentist services in Broken Arrow, Oklahoma. Licensed in Oklahoma. Registered with an NPI since 2014.

Licensed in
OK
In the registry since
2014
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1950 W Kenosha St
Broken Arrow, OK 74012-8944
Phone: (405) 945-8941
Fax: (405) 945-8959
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence 3723 (OK)

Record details

NPI number1780001636
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Glenn Ashmore — Owner / President · (405) 949-0123
NPI enumeratedMarch 27, 2014
Last updated in NPPESJune 22, 2021
Certification dateJune 22, 2021
Mailing address2828 Nw 30th St, Oklahoma City, OK 73112-7404

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