C.C. Trejo D.D.S., P.a.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

17954 Issued in TX

Legal business name

C.C. TREJO D.D.S., P.A.

Practice address

2600 S Gessner Rd
Suite 304
Houston, TX 77063-3200

Phone

(713) 785-4867

Fax

(713) 785-1191

NPI assigned

Aug 8, 2012

Organization subpart

No

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

Authorized official

Name

Mrs. Corletta Trejo, DDS

Title

Dentist

Phone

(713) 785-4867

Specialties & licenses 2

Addresses

Locations

Practitioners 2

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

• Cornelia C Trejo, D. D. S.

  • General Practice Dentistry
  • Houston, TX
  • NPI 1669558649
  NPD (past)
• Pedro M. Trejo, D.D.S., M.S.

  • Periodontics
  • Houston, TX
  • NPI 1942337019
  NPD (past)

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

{
    "created_epoch": "1344384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1344384000000",
    "number": "1053668137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 S GESSNER RD",
            "address_2": "SUITE 304",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770633200",
            "telephone_number": "713-785-4867",
            "fax_number": "713-785-1191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 S GESSNER RD",
            "address_2": "SUITE 304",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770633200",
            "telephone_number": "713-785-4867",
            "fax_number": "713-785-1191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "C.C. TREJO D.D.S., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-08",
        "last_updated": "2012-08-08",
        "status": "A",
        "authorized_official_last_name": "TREJO",
        "authorized_official_first_name": "CORLETTA",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "713-785-4867",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "17954",
            "primary": true
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": "TX",
            "license": "19095",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Houston, TX
• Providers in Houston, 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 Aug 8, 2012; 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.