# IDEAL DENTAL NORTHWEST OKLAHOMA CITY

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1366337966
- **Authorized official:** CAROL CANAVA (VP REVENUE CYCLE)
- **Authorized official phone:** (972) 331-8079

## Contact information

- **Practice address:** 3629 NW 178TH STREET, STE D, OKLAHOMA CITY, OK 73012
- **Practice address phone:** (972) 361-0600
- **Mailing address:** 12750 MERIT DR STE 1100, DALLAS, TX 75251-1302

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | — | Yes |

## Other

- **Enumeration date:** 06/12/2025
- **Last updated:** 06/12/2025