Organization Active NPI

Mountain Smiles - DSS PLLC

  • Endodontics
  • Saginaw, TX
National Provider Identifier
1205731320
Registry record updated Oct 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
Legal business name
MOUNTAIN SMILES - DSS PLLC
Practice address
713 W Bailey Boswell Rd
Saginaw, TX 76179-1031
Phone
(817) 847-4040
NPI assigned
Oct 9, 2026
Last updated
Oct 9, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2026

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

Authorized official

Name
Angel Gimenez
Title
Credentialing Manager
Phone
(719) 300-5933

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X Primary
Oral and Maxillofacial Pathology Dentistry 1223P0106X

Addresses

Primary practice location

713 W Bailey Boswell Rd
Saginaw, TX 76179-1031

Mailing address

713 W Bailey Boswell Rd
Saginaw, TX 76179-1031
Phone (817) 847-4040

National Provider Directory

National Provider Directory

Locations

713 W Bailey Boswell Rd
Saginaw, TX 76179
Phone (817) 847-4040

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1791504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1791504000000",
    "number": "1205731320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "713 W BAILEY BOSWELL RD",
            "city": "SAGINAW",
            "state": "TX",
            "postal_code": "761791031",
            "telephone_number": "817-847-4040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "713 W BAILEY BOSWELL RD",
            "city": "SAGINAW",
            "state": "TX",
            "postal_code": "761791031",
            "telephone_number": "817-847-4040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN SMILES - DSS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-10-09",
        "last_updated": "2026-10-09",
        "certification_date": "2026-10-09",
        "status": "A",
        "authorized_official_last_name": "GIMENEZ",
        "authorized_official_first_name": "ANGEL",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "719-300-5933"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223P0106X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saginaw, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2026; 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.