Waco Dental and Orthodontics, PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

WACO DENTAL AND ORTHODONTICS, PLLC

Doing business as

Rodeo Dental and Orthodontics

Practice address

5201 Bosque Blvd Ste 200
Waco, TX 76710-4676

Phone

(817) 529-8151

Fax

(817) 928-1681

NPI assigned

Sep 29, 2021

Last updated

Oct 3, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Raffy Kouyoumdjian, DMD

Title

Owner

Phone

(818) 653-9799

Specialties & licenses 1

Addresses

Other names 1

• RODEO DENTAL AND ORTHODONTICS Doing business as

Locations

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

{
    "created_epoch": "1632873600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759449600000",
    "number": "1114699089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8505 FREEPORT PKWY STE 600",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750632549",
            "telephone_number": "817-529-8151",
            "fax_number": "817-928-1681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5201 BOSQUE BLVD STE 200",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767104676",
            "telephone_number": "817-529-8151",
            "fax_number": "817-928-1681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WACO DENTAL AND ORTHODONTICS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-29",
        "last_updated": "2025-10-03",
        "certification_date": "2025-10-03",
        "status": "A",
        "authorized_official_last_name": "KOUYOUMDJIAN",
        "authorized_official_first_name": "RAFFY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "818-653-9799",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RODEO DENTAL AND ORTHODONTICS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Dentistry in Waco, TX
• Providers in Waco, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 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.