Fanny Kamwa Agnero, DMD,MPH

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

27861 Issued in TX

Practice address

5342 E US Highway 83 Ste 3
Rio Grande City, TX 78582-9433

Phone

(956) 317-1365

NPI assigned

Jun 30, 2011

Last updated

Mar 5, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Rio Grande City Pediatric Dentistry PLLC

  • Pediatric Dentistry
  • Rio Grande City, TX
  • NPI 1679817183
  NPD (past)

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

{
    "created_epoch": "1309392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646438400000",
    "number": "1063709830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5342 E US HIGHWAY 83 STE 3",
            "city": "RIO GRANDE CITY",
            "state": "TX",
            "postal_code": "785829433",
            "telephone_number": "956-317-1365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5342 E US HIGHWAY 83 STE 3",
            "city": "RIO GRANDE CITY",
            "state": "TX",
            "postal_code": "785829433",
            "telephone_number": "956-317-1365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGNERO",
        "first_name": "FANNY",
        "middle_name": "KAMWA",
        "name_prefix": "Dr.",
        "credential": "DMD,MPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-30",
        "last_updated": "2022-03-05",
        "certification_date": "2022-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DI02487800",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TX",
            "license": "27861",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joe Angel Adame Jr., PT, DPT
• Sanjuanita Adame
• Adoro Healthcare LLC
• Adult & Pediatric Medicine by Sandubs
• Affordable Medical Equipment and Supplies LLC
• Agua Viva Home Care LLC
• Agua Viva Home Care LLC
• Gerardo Aguirre, L.A.T.
• Khizar Ahsan, M.D.
• Leidy Alaffa, PTA

• Pediatric Dentistry in Rio Grande City, TX
• Providers in Rio Grande City, TX by specialty
• Pediatric Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2022; 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.