Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dental Depot of 164th & Portland PLLC

Organization General Practice Dentistry · NPI 1639895402

Dental Depot of 164th & Portland PLLC is a General Practice Dentistry in Oklahoma City, Oklahoma. Registered with an NPI since 2022.

In the registry since
2022
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

16401 Ironstone Pl
Oklahoma City, OK 73013
Phone: (405) 900-7123
Fax: (405) 635-1252
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X

Record details

NPI number1639895402
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Gaylon Zissa — Director Of Provider Relations · (405) 409-3789
NPI enumeratedOctober 13, 2022
Last updated in NPPESOctober 13, 2022
Certification dateOctober 7, 2022
Mailing address16401 Ironstone Place, Oklahoma City, OK 73013

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