Individual provider Active NPI

Noe Luis Jaramillo, DDS

  • General Practice Dentistry
  • Midlothian, TX
National Provider Identifier
1093376238
Registry record updated Jun 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
35148 Issued in TX
Practice address
102 S 7TH St
Midlothian, TX 76065-3212
Phone
(214) 707-1708
NPI assigned
Jun 27, 2019
Last updated
Jun 8, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 8, 2021

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 35148 TX Primary

Addresses

Primary practice location

102 S 7TH St
Midlothian, TX 76065-3212

Mailing address

102 S 7TH St
Midlothian, TX 76065-3212
Phone (214) 707-1708

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
35148TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
A.L.C Dental, PLLC CurrentSince Jun 22, 2021 Accepting new patients
Goliad Dental Care General Practice Past Accepting new patients
Amdg Dental PLLC PastSince Apr 3, 2022 Accepting new patients

Locations

102 S 7th St
Midlothian, TX 76065
Phone (214) 707-1708

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1561593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623110400000",
    "number": "1093376238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 S 7TH ST",
            "city": "MIDLOTHIAN",
            "state": "TX",
            "postal_code": "760653212",
            "telephone_number": "214-707-1708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 S 7TH ST",
            "city": "MIDLOTHIAN",
            "state": "TX",
            "postal_code": "760653212",
            "telephone_number": "214-707-1708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JARAMILLO",
        "first_name": "NOE",
        "middle_name": "LUIS",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-06-27",
        "last_updated": "2021-06-08",
        "certification_date": "2021-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "35148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midlothian, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2021; 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.