DENTAL DEPOT SOUTH
NPI 1578768180
Dentist - General Practice in Oklahoma City, OK

Q: What is Dental Depot South's NPI number?

The NPI number for Dental Depot South is 1578768180. It was assigned to this organization in the NPPES registry on June 15, 2007.

Q: What is Dental Depot South's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Active since June 15, 2007

1024 SW 104TH ST, OKLAHOMA CITY, OK 73139(405) 691-1123(405) 691-2674 Get Directions Write a Review

NPPES record last updated: June 25, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 25, 2021, Aug 22, 2020 (2 updates tracked since 2020).

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About Dental Depot South NPPES

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

DENTAL DEPOT SOUTH (NPI 1578768180) is a healthcare organization registered as a general practice in Oklahoma City, Oklahoma and active in the NPI registry since June 2007. The organization lists Gaylon Zissa, Director Provider Relations, as its authorized official.

NPPES Registry Identity

NPI1578768180

Entity TypeOrganization

Primary Taxonomy1223G0001X

Legal Business NameDENTAL DEPOT SOUTH

Location Address1024 SW 104TH STOklahoma City, OK 73139-2990

Mailing Address2828 Nw 30th StOklahoma City, OK 73112-7404 · (405) 691-1123 · Fax (405) 691-2674

Phone(405) 691-1123

Fax(405) 691-2674

Organization SubpartNo

Authorized OfficialGaylon ZissaDirector Provider Relations · (405) 691-1123

Enumeration DateJune 15, 2007

Last NPPES UpdateJune 25, 20212 updates tracked since enumeration

NPPES CertifiedJune 25, 2021

✔ NPI 1578768180 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers

Taxonomy Code1223G0001X

Definition

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

1024 SW 104TH ST, Oklahoma City, OK 73139

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Other Identifiers 1

Medicaid200100150AOK

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

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. AUGUSTA ACQUAAH DMD

Dentist (Orthodontics and Dentofacial Orthopedics)