Individual provider Active NPI

Luis Orraca, DMD

  • General Practice Dentistry
  • Austin, TX
National Provider Identifier
1164974176
Registry record updated Dec 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
33610 Issued in TX
Practice address
11330 Menchaca Rd
Austin, TX 78748-2879
Phone
(787) 608-9864
NPI assigned
Oct 26, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 3234 PR
General Practice Dentistry 1223G0001X 33610 TX Primary

Addresses

Primary practice location

11330 Menchaca Rd
Austin, TX 78748-2879

Mailing address

177 Betony Loop
Buda, TX 78610-4407
Phone (512) 593-8999

Other practice location 1

18901 IH-35, Suite 100
Kyle, TX 78640
Phone (512) 593-8999

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
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
I20170313000963 PR Order and Referring Only - DentistPractitioner - Dentist 5799069779

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3234PRMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Reach Dental PLLC PastSince Aug 13, 2023 Accepting new patients

Organizations & group practices 1

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": "1477440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701648000000",
    "number": "1164974176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "177 BETONY LOOP",
            "city": "BUDA",
            "state": "TX",
            "postal_code": "786104407",
            "telephone_number": "512-593-8999",
            "fax_number": "512-593-7949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11330 MENCHACA RD",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787482879",
            "telephone_number": "787-608-9864"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18901 IH-35, Suite 100",
            "address_purpose": "LOCATION",
            "city": "Kyle",
            "state": "TX",
            "postal_code": "78640",
            "country_code": "US",
            "telephone_number": "512-593-8999",
            "fax_number": "512-593-7949",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ORRACA",
        "first_name": "LUIS",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-10-26",
        "last_updated": "2023-12-04",
        "certification_date": "2023-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PR",
            "license": "3234",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "33610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.