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DENTAL DEPOT OF 164TH & PORTLAND PLLC
NPI 1639895402
Dentist - General Practice in Oklahoma City, OK

Active since October 13, 2022
16401 IRONSTONE PLACE, OKLAHOMA CITY, OK 73013(405) 900-7123(405) 635-1252 Get Directions Write a Review

NPPES record last updated: October 13, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dental Depot Of 164th & Portland Pllc NPPES

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

DENTAL DEPOT OF 164TH & PORTLAND PLLC (NPI 1639895402) is a healthcare organization registered as a general practice in Oklahoma City, Oklahoma and active in the NPI registry since October 2022. The organization lists Gaylon Zissa, Director Of Provider Relations, as its authorized official.

NPPES Registry Identity

NPI1639895402
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameDENTAL DEPOT OF 164TH & PORTLAND PLLC
Location Address16401 IRONSTONE PLACEOklahoma City, OK 73013
Mailing Address16401 Ironstone PlaceOklahoma City, OK 73013
Phone(405) 900-7123
Fax(405) 635-1252
Organization SubpartNo
Authorized OfficialGaylon ZissaDirector Of Provider Relations · (405) 409-3789
Enumeration DateOctober 13, 2022
NPPES CertifiedOctober 7, 2022
✔ NPI 1639895402 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.
16401 IRONSTONE PLACE, Oklahoma City, OK 73013
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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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Sunflower Health Plan and more.Insurance ›

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 Of 164th & Portland PLLC's NPI number?

The NPI number for Dental Depot Of 164th & Portland PLLC is 1639895402. It was assigned to this organization in the NPPES registry on October 13, 2022.

Where is Dental Depot Of 164th & Portland PLLC located?

Dental Depot Of 164th & Portland PLLC is located at 16401 Ironstone Place, Oklahoma City, OK 73013. The listed phone number is (405) 900-7123.

What is Dental Depot Of 164th & Portland PLLC's specialty?

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

What insurance does Dental Depot Of 164th & Portland PLLC accept?

Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Sunflower Health Plan, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 1 other insurer list Dental Depot Of 164th & Portland PLLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Dental Depot Of 164th & Portland PLLC was last updated on October 13, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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.