Type 2 · Organization ✓ Active NPI ✓ Valid NPI checksum

Restore Dermatology Clinic LLC

Dermatology Physician in Broken Arrow, OK · enumerated 2025 · authorized official Jessica Graves, Sole Member.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1336002302

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Registry record

Entity type Organization (Type 2)

Legal business name Restore Dermatology Clinic LLC

Practice address 4700 W Urbana St Ste 100, Broken Arrow, OK, 74012

Phone (539) 281-3101

Enumeration date Dec 6, 2025

Last updated in NPPES Dec 17, 2025

Taxonomy & classification

207N00000X Dermatology Physician Allopathic & Osteopathic Physicians Primary

Authorized official

Name Jessica Graves

Title Sole Member

Phone (539) 281-3101

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

Where is Restore Dermatology Clinic LLC located?

The practice location on file with NPPES is in Broken Arrow, OK.

How current is this record?

Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2025-12-17. Verify at npiregistry.cms.hhs.gov.

Providers at this address

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Jessica Graves Medical Physician Assistant · Broken Arrow, OK NPI 1407120066

Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2025-12-17.