Individual provider Active NPI

Deborah L Kizziar, D.D.S., M.D.

  • Oral and Maxillofacial Surgery (Dentist)
  • Spokane, WA
National Provider Identifier
1417953100
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
8428 Issued in WA
Practice address
123 W Francis Ave
Spokane, WA 99205-6348
Phone
(509) 928-8800
Fax
(509) 321-0154
NPI assigned
Jun 27, 2005
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 8428 WA Primary

Addresses

Primary practice location

123 W Francis Ave
Spokane, WA 99205-6348

Mailing address

Oral Surgery Plus
123 W Francis
Spokane, WA 99205
Phone (509) 928-8800

Other identifiers 1

IdentifierTypeStateIssuer
5032628MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
8428WAMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Oral Surgery Plus P.S. Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1119830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1417953100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ORAL SURGERY PLUS",
            "address_2": "123 W FRANCIS",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "99205",
            "telephone_number": "509-928-8800",
            "fax_number": "509-321-0154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 W FRANCIS AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992056348",
            "telephone_number": "509-928-8800",
            "fax_number": "509-321-0154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIZZIAR",
        "first_name": "DEBORAH",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-27",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "WA",
            "license": "8428",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5032628",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.