Dental Depot Orthodontics South PLLC
NPI 1629491832ActiveOrganization· Dentist, Orthodontics and Dentofacial Orthopedics· Oklahoma City, OK
Dentist, Orthodontics and Dentofacial Orthopedics in Oklahoma City, Oklahoma, registered in NPPES in January 2014, part of Dental Depot Westminster Village LLC. The authorized official on file is Gaylon Zissa, Director.
Overview
| NPI | 1629491832 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Dental Depot Westminster Village LLC |
| NPI issued | Jan 23, 2014 |
| Last updated in NPPES | Jan 11, 2024 |
| Certified by provider | Jan 11, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist, Orthodontics and Dentofacial Orthopedics Primary | 1223X0400X | 73 | OK |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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