Provider Demographics
NPI:1174412852
Name:BESSON, KATIE CORRINE (DMD)
Entity type:Individual
Prefix:DR
First Name:KATIE
Middle Name:CORRINE
Last Name:BESSON
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:KATIE
Other - Middle Name:CORRINE
Other - Last Name:KAP
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD
Mailing Address - Street 1:2628 CEDAR TREE RD APT C
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73120-0124
Mailing Address - Country:US
Mailing Address - Phone:775-901-1301
Mailing Address - Fax:
Practice Address - Street 1:1200 CHILDRENS AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73104-4637
Practice Address - Country:US
Practice Address - Phone:405-271-4700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-30
Last Update Date:2025-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK8116122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist