Organization Active NPI

Rosa Mora D.D.S

  • Dentist
  • Alton, TX
National Provider Identifier
1114154952
Registry record updated Jun 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
20419 Issued in TX
Legal business name
ROSA MORA D.D.S
Practice address
921 E Main Ave
Suite2
Alton, TX 78573-0952
Phone
(956) 583-5050
Fax
(956) 583-5067
NPI assigned
Jun 19, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2009

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

Authorized official

Name
Mrs. Rosa Mora, DDS
Title
Owner
Phone
(956) 583-5050

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 20419 TX Primary

Addresses

Primary practice location

921 E Main Ave
Suite2
Alton, TX 78573-0952

Mailing address

921 E Main Ave
Suite 2
Mission, TX 78573
Phone (956) 583-5050

Other identifiers 1

IdentifierTypeStateIssuer
151616301MedicaidTX

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1245369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245369600000",
    "number": "1114154952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "921 E MAIN AVE",
            "address_2": "SUITE 2",
            "city": "MISSION",
            "state": "TX",
            "postal_code": "78573",
            "telephone_number": "956-583-5050",
            "fax_number": "956-583-5067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "921 E MAIN AVE",
            "address_2": "SUITE2",
            "city": "ALTON",
            "state": "TX",
            "postal_code": "785730952",
            "telephone_number": "956-583-5050",
            "fax_number": "956-583-5067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROSA MORA D.D.S",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-19",
        "last_updated": "2009-06-19",
        "status": "A",
        "authorized_official_last_name": "MORA",
        "authorized_official_first_name": "ROSA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "956-583-5050",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "TX",
            "license": "20419",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "151616301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alton, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2009; 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.