Individual provider Active NPI

Javier Andres Velez Betancourt, DMD

  • General Practice Dentistry
  • Laredo, TX
National Provider Identifier
1013607472
Registry record updated Dec 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
40843 Issued in TX
Practice address
1515 Pappas St
Laredo, TX 78041-1705
Phone
(787) 505-9566
NPI assigned
May 9, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 40843 TX Primary

Addresses

Primary practice location

1515 Pappas St
Laredo, TX 78041-1705

Mailing address

7211 Lake Victoria Rd
Laredo, TX 78041-1966
Phone (787) 505-9566

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240919003522 TX Practitioner - Dentist 3274074067 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40843TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Gateway Community Health Center, Inc CurrentSince Aug 26, 2024 Accepting new patients
Gateway Community Health Center, Inc CurrentSince Aug 26, 2024 Accepting new patients

Locations

1515 Pappas St
Laredo, TX 78041
Phone (956) 523-3642

Networks

  • TX HMO D-SNP

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1683590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734393600000",
    "number": "1013607472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7211 LAKE VICTORIA RD",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780411966",
            "telephone_number": "787-505-9566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 PAPPAS ST",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780411705",
            "telephone_number": "787-505-9566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VELEZ BETANCOURT",
        "first_name": "JAVIER",
        "middle_name": "ANDRES",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-05-09",
        "last_updated": "2024-12-17",
        "certification_date": "2024-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "40843",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laredo, TX

Sources for this page

Verify at the official NPI Registry.