Edgar Edward Elizondo, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

14925 Issued in TX

Practice address

7254 Blanco Rd
Suite 207
San Antonio, TX 78216

Phone

(210) 341-7116

Fax

(210) 366-9479

NPI assigned

Mar 22, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• San Pedro Smiles P. a.

  dba Blanco Smiles Dental Center

  • Dental Clinic/Center
  • San Antonio, TX
  • NPI 1073954228
  NPD (past)

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1023134525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7254 BLANCO RD",
            "address_2": "SUITE 207",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78216",
            "telephone_number": "210-341-7116",
            "fax_number": "210-366-9479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7254 BLANCO RD",
            "address_2": "SUITE 207",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78216",
            "telephone_number": "210-341-7116",
            "fax_number": "210-366-9479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELIZONDO",
        "first_name": "EDGAR",
        "middle_name": "EDWARD",
        "name_prefix": "Mr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "14925",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Rose Elizondo, D.D.S.
• Barbara Alexandra Elizondo
• Crista Marie Elizondo, LM
• Crystal Ann Elizondo
• Denise Elizondo, MD
• Emma Margot Elizondo, MD
• Guadalupe I Elizondo, LPC
• Ivan Elizondo, MS, LPC
• Jorge Alejandro Elizondo
• Joseph Stephen Elizondo, M.D.

• General Practice Dentistry in San Antonio, TX
• Providers in San Antonio, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.