Organization Active NPI

Maria Elba Garcia-Ibancovichi DDS

  • General Practice Dentistry
  • Dallas, TX
National Provider Identifier
1114148897
Registry record updated Sep 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
16354 Issued in TX
Legal business name
MARIA ELBA GARCIA-IBANCOVICHI DDS
Practice address
618 W Jefferson Blvd
Dallas, TX 75208-4724
Phone
(214) 946-2277
Fax
(214) 941-6068
NPI assigned
May 1, 2007
Last updated
Sep 29, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2011

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

Authorized official

Name
Martha Alicia Alvarez
Title
Office Manager
Phone
(214) 946-2277

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 16354 TX Primary

Addresses

Primary practice location

618 W Jefferson Blvd
Dallas, TX 75208-4724

Mailing address

618 W Jefferson Blvd
Dallas, TX 75208-4724
Phone (214) 946-2277

Other identifiers 2

IdentifierTypeStateIssuer
B16354-01OtherTXCHIP
1614059-01MedicaidTX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317254400000",
    "number": "1114148897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "618 W JEFFERSON BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752084724",
            "telephone_number": "214-946-2277",
            "fax_number": "214-941-6068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "618 W JEFFERSON BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752084724",
            "telephone_number": "214-946-2277",
            "fax_number": "214-941-6068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARIA ELBA GARCIA-IBANCOVICHI DDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-01",
        "last_updated": "2011-09-29",
        "status": "A",
        "authorized_official_last_name": "ALVAREZ",
        "authorized_official_first_name": "MARTHA",
        "authorized_official_middle_name": "ALICIA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "214-946-2277"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "16354",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHIP",
            "identifier": "B16354-01",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1614059-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2011; 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.