# DENTAL DEPOT OF 88TH & THUNDERBIRD, PLLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1376380170
- **Authorized official:** GAYLON ZISSA (DIRECTOR OF PROVIDER RELATIONS)
- **Authorized official phone:** (405) 945-8941

## Contact information

- **Practice address:** 8850 W THUNDERBIRD RD, PEORIA, AZ 85381-4812
- **Practice address phone:** (623) 352-3123
- **Mailing address:** 2828 NW 30TH ST, OKLAHOMA CITY, OK 73112-7404
- **Mailing address phone:** (623) 352-3123

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 07/10/2024
- **Last updated:** 07/10/2024