Active NPI
Mario S Valdes
- Orthodontics and Dentofacial Orthopedics Dentistry
- Austin, TX
National Provider Identifier
1205223260
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 30387
- Practice address
- 7517 Cameron Rd
Suite 106
Austin, TX 78752-2057 - Phone
- (512) 278-1232
- NPI assigned
- Apr 16, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 30387 | TX | Primary |
Addresses
Primary practice location
7517 Cameron Rd
Suite 106
Austin, TX 78752-2057
Mailing address
3050 Tamarron Blvd
Apt 2301
Austin, TX 78746-8035
Phone (512) 496-3732
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30387 | TX | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1429142400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1430870400000",
"number": "1205223260",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3050 TAMARRON BLVD",
"address_2": "APT 2301",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787468035",
"telephone_number": "512-496-3732"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7517 CAMERON RD",
"address_2": "SUITE 106",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787522057",
"telephone_number": "512-278-1232"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VALDES",
"first_name": "MARIO",
"middle_name": "S",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-04-16",
"last_updated": "2015-05-06",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "TX",
"license": "30387",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.