KIMIKO AND TEDESCO LLC NPI 1396497319

NPI Information

  • NPI: 1396497319
  • Provider Name: KIMIKO AND TEDESCO LLC
  • Classification: Dermatology - 207NS0135X
  • Specialization: Procedural Dermatology
  • Entity Type: Organization
  • :
  • Address: 11911 S OXFORD AVE STE 200
    TULSA, OK
    ZIP 74137
  • Phone: (918) 600-0026

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NPI Details

KIMIKO AND TEDESCO LLC is a procedural dermatology dermatology in Tulsa, OK. The provider is procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery, chemical surgery, cryosurgery (liquid nitrogen), electrosurgery, aspiration surgery, liposuction, injection of filler substances, and Mohs micrographic controlled surgery (a special technique for the removal of growths, especially skin cancers). KIMIKO AND TEDESCO LLC NPI is 1396497319. The provider is registered as an organization entity type and is a multi-specialty group.
The provider .

The provider's business location address is:

11911 S OXFORD AVE STE 200
TULSA, OK
ZIP 74137-778
Phone: (918) 600-0026
Fax: (918) 600-0690

The provider's authorized official is Breann H Tedesco .
The authorized official title is Office Manager and has the following contact phone number (918) 600-0026.

The enumeration date for this NPI number is 1/20/2022 and was last updated on 9/9/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12086S0122XSurgeryPlastic and Reconstructive SurgeryNo
22082S0099XPlastic SurgeryPlastic Surgery Within the Head and NeckNo
3207NS0135XDermatologyProcedural DermatologyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11790951747OTHEROKLAHOMACOMMUNITY CARE
21790951747MEDICAIDOKLAHOMA
31790951747OTHEROKLAHOMAPHCS
41790951747OTHEROKLAHOMAAETNA
51790951747OTHEROKLAHOMAVA
61790951747OTHEROKLAHOMACIGNA
71790951747OTHEROKLAHOMAUNITED HEALTHCARE
81790951747OTHEROKLAHOMABLUE CROSS BLUE SHIELD
91790951747OTHEROKLAHOMAPREFERED COMMUNITY CHOICE
101790951747OTHEROKLAHOMAGLOBAL HEALTH
111790951747OTHEROKLAHOMAHEALTH CHOICE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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