Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Gary E Theobald, DMD

Individual provider General Practice Dentistry · NPI 1467597104

Gary E Theobald, DMD is a General Practice Dentistry in Broken Arrow, Oklahoma. Practices as a sole proprietor. Licensed in Oklahoma.

Licensed in
OK
In the registry since
2007
What do these letters mean?
DMD — Doctor of Dental Medicine
A dentist. Identical training and licensing to a DDS.

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Practice location Address checks out

2619 S Elm Pl
Broken Arrow, OK 74012-7878
Phone: (918) 455-0811
Fax: (918) 451-4787
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X · Licence 3804 (OK)

Record details

NPI number1467597104
Entity typeIndividual (Type 1)
GenderMale
Credentials DMD
Sole proprietorYes
NPI enumeratedFebruary 20, 2007
Last updated in NPPESJuly 8, 2007

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