NPIMap

Organization Active NPI

Denta Dental of Odessa PLLC

  • General Practice Dentistry
  • Odessa, TX
National Provider Identifier
1013633502
Registry record updated Jul 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
DENTA DENTAL OF ODESSA PLLC
Practice address
1508 N Grandview Ave Ste 3
Odessa, TX 79761-3040
Phone
(432) 367-8907
Fax
(432) 362-0949
NPI assigned
Oct 17, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2023

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

Authorized official

Name
Dr. Loi Ta, DDSNPI 1912491218
Title
President
Phone
(901) 606-2355

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

1508 N Grandview Ave Ste 3
Odessa, TX 79761-3040

Mailing address

1508 N Grandview Ave Ste 3
Odessa, TX 79761-3040
Phone (432) 367-8907

Other identifiers 1

IdentifierTypeStateIssuer
1912491218OtherTXNPI I

Other names 1

  • Denta Dental of Odessa Doing business as

National Provider Directory

National Provider Directory

Locations

1508 N Grandview Ave
Ste 3
Odessa, TX 79761
Phone (432) 367-8907

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1665964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688169600000",
    "number": "1013633502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1508 N GRANDVIEW AVE STE 3",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797613040",
            "telephone_number": "432-367-8907",
            "fax_number": "432-362-0949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1508 N GRANDVIEW AVE STE 3",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797613040",
            "telephone_number": "432-367-8907",
            "fax_number": "432-362-0949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTA DENTAL OF ODESSA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-17",
        "last_updated": "2023-07-01",
        "certification_date": "2023-07-01",
        "status": "A",
        "authorized_official_last_name": "TA",
        "authorized_official_first_name": "LOI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "901-606-2355",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI I",
            "identifier": "1912491218",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Denta Dental of Odessa",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Odessa, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2023; 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.