Individual provider Active NPI

Ernesto Gerardo Trevino, DDS

  • Dentist
  • Edinburg, TX
National Provider Identifier
1235387895
Registry record updated Sep 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
22876 Issued in TX
Practice address
5421 S McColl Rd
Edinburg, TX 78539-9183
Phone
(956) 994-9500
Fax
(956) 412-1146
NPI assigned
Sep 8, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 17, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 22876 TX Primary

Addresses

Primary practice location

5421 S McColl Rd
Edinburg, TX 78539-9183

Mailing address

5421 S McColl Rd
Edinburg, TX 78539-9183
Phone (956) 994-9500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20201027003329 TX Order and Referring Only - DentistPractitioner - Dentist 4183034416

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22876TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
RGV Endodontics LLP Past 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1220832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253145600000",
    "number": "1235387895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5421 S MCCOLL RD",
            "city": "EDINBURG",
            "state": "TX",
            "postal_code": "785399183",
            "telephone_number": "956-994-9500",
            "fax_number": "956-412-1146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5421 S MCCOLL RD",
            "city": "EDINBURG",
            "state": "TX",
            "postal_code": "785399183",
            "telephone_number": "956-994-9500",
            "fax_number": "956-412-1146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TREVINO",
        "first_name": "ERNESTO",
        "middle_name": "GERARDO",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-09-08",
        "last_updated": "2009-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "22876",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edinburg, TX

Sources for this page

Verify at the official NPI Registry.