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KIMIKO AND TEDESCO LLC NPI 1396497319


NPI Information

NPI: 1396497319
Provider Name: KIMIKO AND TEDESCO LLC

Doing Business As: GREEN COUNTRY SURGICAL ARTS

Classification: Dermatology - 207NS0135X
Entity Type: Organization

Specialization: Procedural Dermatology

Address:
5555 E 71ST STREET
SUITE 7255
TULSA, OK
ZIP 74136
Phone: (918) 600-0026
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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 Is Doing Business As Green Country Surgical Arts.

The provider's business location address is:

5555 E 71ST STREET
SUITE 7255
TULSA, OK
ZIP 74136
Phone: (918) 600-0026
Fax: (918) 600-0024

The provider's authorized official is Jamie Leeann Hogue .
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 2/2/2023.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12082S0099XPlastic SurgeryPlastic Surgery Within the Head and NeckNo
22086S0122XSurgeryPlastic and Reconstructive SurgeryNo
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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11790951747OTHEROKLAHOMAAETNA
21790951747OTHEROKLAHOMAHEALTH CHOICE
31790951747OTHEROKLAHOMAGLOBAL HEALTH
41790951747OTHEROKLAHOMACOMMUNITY CARE
51790951747OTHEROKLAHOMAPREFERED COMMUNITY CHOICE
61790951747OTHEROKLAHOMABLUE CROSS BLUE SHIELD
71790951747OTHEROKLAHOMAUNITED HEALTHCARE
81790951747OTHEROKLAHOMACIGNA
91790951747OTHEROKLAHOMAVA
101790951747MEDICAIDOKLAHOMA
111790951747OTHEROKLAHOMAPHCS

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: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.