Dental Depot Orthodontics 83Rd and Union Hills, PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

DENTAL DEPOT ORTHODONTICS 83RD AND UNION HILLS, PLLC

Practice address

18855 N 83Rd Ave Ste B
Peoria, AZ 85382-2806

Phone

(623) 352-0195

NPI assigned

Jun 3, 2024

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 2

Addresses

Locations

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

{
    "created_epoch": "1717372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717372800000",
    "number": "1396586400",
    "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": "623-267-4129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18855 N 83RD AVE STE B",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853822806",
            "telephone_number": "623-352-0195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL DEPOT ORTHODONTICS 83RD AND UNION HILLS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-03",
        "last_updated": "2024-06-03",
        "certification_date": "2024-06-03",
        "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": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angelina Denourie
• Denova Collaborative Health, LLC
• Dental Care by Design PC
• Dental Depot of 83Rd & Union Hills PLLC
• Dental Depot of 88TH & Thunderbird, PLLC
• Dental Excellence PLLC
• Dental One, Inc.
• Dentists of Peoria, LLP
• Lucy Denton, SLP
• Rosemary Theresa Depaoli, M.D.

• Dental Clinic/Center in Peoria, AZ
• Providers in Peoria, AZ by specialty
• Dental Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2024; 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.