Individual provider Active NPI

Abrefi-Kete Asare, DDS

  • Pediatric Dentistry
  • Laredo, TX
National Provider Identifier
1063893808
Registry record updated Oct 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
31036 Issued in TX
Practice address
2316 S Zapata Hwy Ste 190
Laredo, TX 78046-6590
Phone
(956) 284-0600
NPI assigned
Jun 17, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 31036 TX
General Practice Dentistry 1223G0001X 31036 TX
Pediatric Dentistry 1223P0221X 31036 TX Primary

Addresses

Primary practice location

2316 S Zapata Hwy Ste 190
Laredo, TX 78046-6590

Mailing address

1090 Northchase Pkwy SE
Suite 290
Marietta, GA 30067-6405
Phone (678) 904-5665

Other identifiers 1

IdentifierTypeStateIssuer
F0217797OtherTXDPS

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
I20150928001658 TX Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 6507174380

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
31036TXMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Palomita Dental LLC General Practice Current Accepting new patients

Organizations & group practices 1

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": "1434499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633651200000",
    "number": "1063893808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1090 NORTHCHASE PKWY SE",
            "address_2": "SUITE 290",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300676405",
            "telephone_number": "678-904-5665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2316 S ZAPATA HWY STE 190",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780466590",
            "telephone_number": "956-284-0600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ASARE",
        "first_name": "ABREFI-KETE",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-17",
        "last_updated": "2021-10-08",
        "certification_date": "2021-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "31036",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "31036",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TX",
            "license": "31036",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DPS",
            "identifier": "F0217797",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Laredo, TX

Sources for this page

Verify at the official NPI Registry.