Lucrecia Jane Ceballos

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

38245 Issued in TX

Practice address

1304 Village Creek Dr Ste 400
Plano, TX 75093-4457

Phone

(214) 480-4112

NPI assigned

Mar 29, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Athena Dental PLLC

  • Endodontics
  • McKinney, TX
  • NPI 1891657615
  NPD Authorized official

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

{
    "created_epoch": "1648512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650499200000",
    "number": "1194465328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2975 BLACKBURN ST APT 1719",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752043491",
            "telephone_number": "215-239-1724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1304 VILLAGE CREEK DR STE 400",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750934457",
            "telephone_number": "214-480-4112"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "36 N 3rd St Apt 2R",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191062116",
            "country_code": "US",
            "telephone_number": "215-239-1724",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JANE CEBALLOS",
        "first_name": "LUCRECIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-29",
        "last_updated": "2022-04-21",
        "certification_date": "2022-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": "TX",
            "license": "38245",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lucreciajane@hotmail.com",
            "affiliation": "N",
            "address_1": "36 N 3rd St Apt 2R",
            "city": "Philadelphia",
            "state": "PA",
            "country_code": "US",
            "postal_code": "191062116",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Tyler James, LPC, MA
• Jamili Enterprises, Inc.
• Ruby Jamison, FNP-C
• Samah Jamous
• Ronald Janak
• Chloe Christina Janecek
• Janet D. Pitts, D.C. P.a.
• Cindy Kim Jang, PA-C
• Woo Seok Jang, D.D.S.
• Halima Saadia Janjua, M.D.

• Endodontics in Plano, TX
• Providers in Plano, TX by specialty
• Endodontics in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2022; 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.