Dental Depot Orthodontics Moore, PLLC

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

Legal business name

DENTAL DEPOT ORTHODONTICS MOORE, PLLC

Practice address

2709 S I 35 Frontage Rd Ste a
Moore, OK 73160-2715

Phone

(405) 957-5440

Fax

(405) 957-5542

NPI assigned

Jan 31, 2025

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Gaylon Zissa

Title

Director of Provider Relations

Phone

(405) 945-8941

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1738281600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738281600000",
    "number": "1205649282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2828 NW 30TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731127404",
            "telephone_number": "405-945-8941",
            "fax_number": "405-945-8959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2709 S I 35 FRONTAGE RD STE A",
            "city": "MOORE",
            "state": "OK",
            "postal_code": "731602715",
            "telephone_number": "405-957-5440",
            "fax_number": "405-957-5542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL DEPOT ORTHODONTICS MOORE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-31",
        "last_updated": "2025-01-31",
        "certification_date": "2025-01-31",
        "status": "A",
        "authorized_official_last_name": "ZISSA",
        "authorized_official_first_name": "GAYLON",
        "authorized_official_title_or_position": "DIRECTOR OF PROVIDER RELATIONS",
        "authorized_official_telephone_number": "405-945-8941"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allison Clanton Deimund, M.A., CCC-SLP
• Vanessa Renee Delgadillo
• Kenneth Demasters
• Deni Foughty PH.D PLLC
• Dental Depot of Moore, PLLC
• Dental Professionals of Oklahoma, PC
• Dentists of Moore and Orthodontics
• Areaunna Detweiler
• Orlando A Diaz, OD
• Andrew Dieckmann, PT, DPT, LAT, ATC

• Orthodontics and Dentofacial Orthopedics Dentistry in Moore, OK
• Providers in Moore, OK by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.