Organization Active NPI

Saint Joseph Oral & Maxillofacial

  • Oral and Maxillofacial Pathology Dentistry
  • Laredo, TX
National Provider Identifier
1104956630
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Pathology DentistryTaxonomy code 1223P0106X
Legal business name
SAINT JOSEPH ORAL & MAXILLOFACIAL
Practice address
1519 E Bustamante St
Suite B
Laredo, TX 78041-5305
Phone
(956) 795-1010
Fax
(956) 795-1040
NPI assigned
Mar 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Cesar Trevino, D.D.S.NPI 1811027428
Title
Owner
Phone
(956) 795-1010

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Pathology DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0106X Primary

Addresses

Primary practice location

1519 E Bustamante St
Suite B
Laredo, TX 78041-5305

Mailing address

1519 E Bustamante St
Suite B
Laredo, TX 78041-5305
Phone (956) 795-1010

National Provider Directory

National Provider Directory

Locations

1519 E Bustamante St
#B
Laredo, TX 78041
Phone (956) 568-3009

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104956630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1519 E BUSTAMANTE ST",
            "address_2": "SUITE B",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780415305",
            "telephone_number": "956-795-1010",
            "fax_number": "956-795-1040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1519 E BUSTAMANTE ST",
            "address_2": "SUITE B",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780415305",
            "telephone_number": "956-795-1010",
            "fax_number": "956-795-1040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAINT JOSEPH ORAL & MAXILLOFACIAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TREVINO",
        "authorized_official_first_name": "CESAR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "956-795-1010",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223P0106X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laredo, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.