DENTAL DEPOT OF ORTHODONTICS MESA, PLLC
NPI 1912748260
Clinic/Center - Dental in Mesa, AZ

Active since June 03, 2024
2311 W BROADWAY RD STE B, MESA, AZ 85202(623) 352-0196 Get Directions Write a Review

NPPES record last updated: June 3, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dental Depot Of Orthodontics Mesa, Pllc NPPES

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

DENTAL DEPOT OF ORTHODONTICS MESA, PLLC (NPI 1912748260) is a healthcare organization registered as a dental in Mesa, 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

NPI1912748260
Entity TypeOrganization
Primary Taxonomy261QD0000X
Legal Business NameDENTAL DEPOT OF ORTHODONTICS MESA, PLLC
Location Address2311 W BROADWAY RD STE BMesa, AZ 85202-1005
Mailing Address2828 Nw 30th StOklahoma City, OK 73112-7404 · (623) 352-0196
Organization SubpartNo
Authorized OfficialGaylon ZissaDirector Of Provider Relations · (405) 945-8941
Enumeration DateJune 3, 2024
NPPES CertifiedJune 3, 2024
NPI 1912748260 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
2311 W BROADWAY RD STE B, Mesa, AZ 85202

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 Orthodontics Mesa, PLLC's NPI number?

The NPI number for Dental Depot Of Orthodontics Mesa, PLLC is 1912748260. It was assigned to this organization in the NPPES registry on June 3, 2024.

Where is Dental Depot Of Orthodontics Mesa, PLLC located?

Dental Depot Of Orthodontics Mesa, PLLC is located at 2311 W Broadway Rd Ste B, Mesa, AZ 85202. The listed phone number is (623) 352-0196.

What is Dental Depot Of Orthodontics Mesa, PLLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Dental, with taxonomy code 261QD0000X.

When was this NPI record last updated?

The NPPES record for Dental Depot Of Orthodontics Mesa, PLLC was last updated on June 3, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.