DENTAL DEPOT ORTHODONTICS 83RD AND UNION HILLS, PLLC
NPI 1396586400
Clinic/Center - Dental in Peoria, AZ
Active since June 03, 2024
About Dental Depot Orthodontics 83rd And Union Hills, Pllc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DENTAL DEPOT ORTHODONTICS 83RD AND UNION HILLS, PLLC (NPI 1396586400) is a healthcare organization registered as a dental in Peoria, Arizona and active in the NPI registry since June 2024. The organization lists Gaylon Zissa, Director Of Provider Relations, as its authorized official.
NPPES Registry Identity
NPI1396586400
Entity TypeOrganization
Primary Taxonomy261QD0000X
Legal Business NameDENTAL DEPOT ORTHODONTICS 83RD AND UNION HILLS, PLLC
Location Address18855 N 83RD AVE STE BPeoria, AZ 85382-2806
Mailing Address2828 Nw 30th StOklahoma City, OK 73112-7404 · (623) 267-4129
Phone(623) 352-0195
Organization SubpartNo
Authorized OfficialGaylon ZissaDirector Of Provider Relations · (405) 945-8941
Enumeration DateJune 3, 2024
NPPES CertifiedJune 3, 2024
✔ NPI 1396586400 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses 2
★ Primary SpecialtyClinic/Center · DentalAmbulatory Health Care Facilities
Taxonomy Code261QD0000X
Also ListedClinic/CenterTaxonomy 261Q00000X
18855 N 83RD AVE STE B, Peoria, AZ 85382
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1396586400, enumerated as an "organization" on June 03, 2024.
The provider is located at 18855 N 83RD AVE STE B PEORIA, AZ 85382 and the phone number is (623) 352-0195.
Clinic/Center with taxonomy code 261QD0000X and a focus in Dental.
