Individual provider Active NPI

Gloria Yanez, D.D.S., MS

  • Pediatric Dentistry
  • Austin, TX
National Provider Identifier
1093907602
Registry record updated Apr 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
21450 Issued in TX
Practice address
11800 Dessau Rd Ste 203
Austin, TX 78754-2187
Phone
(512) 490-1212
Fax
(512) 490-1218
NPI assigned
Aug 16, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 21450 TX Primary

Addresses

Primary practice location

11800 Dessau Rd Ste 203
Austin, TX 78754-2187

Mailing address

11800 Dessau Rd Ste 203
Austin, TX 78754-2187
Phone (512) 490-1212

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)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
21450TXMDPediatric Dentist
2145TXMDRehabilitation Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Manzanita Kids Dentistry & Orthodontics, PLLC Pediatric Dentistry CurrentSince Jun 15, 2025 Accepting new patients

Locations

11800 Dessau Rd
Ste 203
Austin, TX 78754
Phone (210) 884-5750

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": "1187222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745884800000",
    "number": "1093907602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11800 DESSAU RD STE 203",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787542187",
            "telephone_number": "512-490-1212",
            "fax_number": "512-490-1218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11800 DESSAU RD STE 203",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787542187",
            "telephone_number": "512-490-1212",
            "fax_number": "512-490-1218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YANEZ",
        "first_name": "GLORIA",
        "name_prefix": "Dr.",
        "credential": "D.D.S., MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-16",
        "last_updated": "2025-04-29",
        "certification_date": "2025-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TX",
            "license": "21450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2025; 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.