Individual provider Active NPI

Maressa Ann Mistretta, DMD

  • Pediatric Dentistry
  • Uvalde, TX
National Provider Identifier
1154842482
Registry record updated Jun 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
33712 Issued in TX
Practice address
135 N High St
Uvalde, TX 78801-5205
Phone
(631) 278-3500
NPI assigned
Jun 27, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DDS-09448 IA
General Practice Dentistry 1223G0001X 33712 TX
Pediatric Dentistry 1223P0221X 33712 TX Primary

Addresses

Primary practice location

135 N High St
Uvalde, TX 78801-5205

Mailing address

101 South Drive
Stony Brook, NY 11794-0001
Phone (631) 632-8989

Other practice location 1

1255 Theatre Dr
Ottumwa, IA 52501-3772
Phone (631) 278-3500

Other practice location 2

101 South Drive
Stony Brook, NY 11794-0001
Phone (631) 632-8989

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170817001663 IA Order and Referring Only - DentistPractitioner - Dentist 1355613910

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DDS-09448IAMDDentist
33712TXMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
MMJS Dental PLLC General Practice Current Accepting new patients
Maressa Mistretta, DMD PLLC Pediatric Dentistry Current Accepting new patients

Locations

135 N High St
Uvalde, TX 78801
Phone (830) 278-3390

Organizations & group practices 2

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": "1498521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782777600000",
    "number": "1154842482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 SOUTH DRIVE",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117940001",
            "telephone_number": "631-632-8989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 N HIGH ST",
            "city": "UVALDE",
            "state": "TX",
            "postal_code": "788015205",
            "telephone_number": "631-278-3500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1255 Theatre Dr",
            "address_purpose": "LOCATION",
            "city": "Ottumwa",
            "state": "IA",
            "postal_code": "525013772",
            "country_code": "US",
            "telephone_number": "631-278-3500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "101 South Drive",
            "address_purpose": "LOCATION",
            "city": "Stony Brook",
            "state": "NY",
            "postal_code": "117940001",
            "country_code": "US",
            "telephone_number": "631-632-8989",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MISTRETTA",
        "first_name": "MARESSA",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-27",
        "last_updated": "2026-06-30",
        "certification_date": "2026-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IA",
            "license": "DDS-09448",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "33712",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TX",
            "license": "33712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Uvalde, TX

Sources for this page

Verify at the official NPI Registry.