Individual provider Active NPI

Denise Hausenfluck, D.D.S

  • General Practice Dentistry
  • Harlingen, TX
National Provider Identifier
1073603874
Registry record updated Oct 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
18077 Issued in TX
Practice address
1214 Dixieland Rd
Suite #4
Harlingen, TX 78552-3351
Phone
(956) 428-5322
Fax
(956) 428-7986
NPI assigned
Oct 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 18077 TX Primary

Addresses

Primary practice location

1214 Dixieland Rd
Suite #4
Harlingen, TX 78552-3351

Mailing address

1214 Dixieland Rd
Suite #4
Harlingen, TX 78552-3351
Phone (956) 428-5322

Other identifiers 2

IdentifierTypeStateIssuer
82D283OtherTXBLUE CROSS BLUE SHIELD
0906208-02MedicaidTX

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
I20160211001526 TX Order and Referring Only - DentistPractitioner - Dentist 4587968557

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18077TXMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413849600000",
    "number": "1073603874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1214 DIXIELAND RD",
            "address_2": "SUITE #4",
            "city": "HARLINGEN",
            "state": "TX",
            "postal_code": "785523351",
            "telephone_number": "956-428-5322",
            "fax_number": "956-428-7986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1214 DIXIELAND RD",
            "address_2": "SUITE #4",
            "city": "HARLINGEN",
            "state": "TX",
            "postal_code": "785523351",
            "telephone_number": "956-428-5322",
            "fax_number": "956-428-7986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAUSENFLUCK",
        "first_name": "DENISE",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-13",
        "last_updated": "2014-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "18077",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "82D283",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0906208-02",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Harlingen, TX

Sources for this page

Verify at the official NPI Registry.