Provider Demographics
NPI:1154162832
Name:EIDSON, AYRIKA (DDS)
Entity type:Individual
Prefix:DR
First Name:AYRIKA
Middle Name:
Last Name:EIDSON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8700 N CEMETERY RD
Mailing Address - Street 2:
Mailing Address - City:YUKON
Mailing Address - State:OK
Mailing Address - Zip Code:73099-8572
Mailing Address - Country:US
Mailing Address - Phone:405-517-3258
Mailing Address - Fax:
Practice Address - Street 1:1226 W BROADWAY ST
Practice Address - Street 2:
Practice Address - City:DRUMRIGHT
Practice Address - State:OK
Practice Address - Zip Code:74030-5826
Practice Address - Country:US
Practice Address - Phone:918-844-4625
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-05
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK78711223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice