DENTAL DEPOT ORTHODONTICS BROKEN ARROW, PLLC
NPI 1508679598
Dentist - Orthodontics and Dentofacial Orthopedics in Broken Arrow, OK

Active since January 31, 2025
1950 W KENOSHA ST STE B, BROKEN ARROW, OK 74012(539) 476-9588 Get Directions Write a Review

NPPES record last updated: January 31, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dental Depot Orthodontics Broken Arrow, Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DENTAL DEPOT ORTHODONTICS BROKEN ARROW, PLLC (NPI 1508679598) is a healthcare organization registered as an orthodontics and dentofacial orthopedics in Broken Arrow, Oklahoma and active in the NPI registry since January 2025. The organization lists Gaylon Zissa, Director Of Provider Relations, as its authorized official.

NPPES Registry Identity

NPI1508679598
Entity TypeOrganization
Primary Taxonomy1223X0400X
Legal Business NameDENTAL DEPOT ORTHODONTICS BROKEN ARROW, PLLC
Location Address1950 W KENOSHA ST STE BBroken Arrow, OK 74012-8944
Mailing Address2828 Nw 30th StOklahoma City, OK 73112-7404 · (405) 945-8941 · Fax (405) 945-8959
Organization SubpartNo
Authorized OfficialGaylon ZissaDirector Of Provider Relations · (405) 945-8941
Enumeration DateJanuary 31, 2025
NPPES CertifiedJanuary 31, 2025
NPI 1508679598 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDentist · Orthodontics and Dentofacial OrthopedicsDental Providers
Taxonomy Code1223X0400X
Definition
That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures.
1950 W KENOSHA ST STE B, Broken Arrow, OK 74012

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Dental Depot Orthodontics Broken Arrow, PLLC's NPI number?

The NPI number for Dental Depot Orthodontics Broken Arrow, PLLC is 1508679598. It was assigned to this organization in the NPPES registry on January 31, 2025.

Where is Dental Depot Orthodontics Broken Arrow, PLLC located?

Dental Depot Orthodontics Broken Arrow, PLLC is located at 1950 W Kenosha St Ste B, Broken Arrow, OK 74012. The listed phone number is (539) 476-9588.

What is Dental Depot Orthodontics Broken Arrow, PLLC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Orthodontics and Dentofacial Orthopedics, with taxonomy code 1223X0400X.

When was this NPI record last updated?

The NPPES record for Dental Depot Orthodontics Broken Arrow, PLLC was last updated on January 31, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.