Individual provider Active NPI

Hector Trevino

  • General Practice Dentistry
  • Port Arthur, TX
National Provider Identifier
1306391719
Registry record updated Aug 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
31910 Issued in TX
Practice address
2780 FM 365
Port Arthur, TX 77640
Phone
(409) 433-9254
NPI assigned
Aug 16, 2016
Last updated
Aug 16, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 31910 TX Primary

Addresses

Primary practice location

2780 FM 365
Port Arthur, TX 77640

Mailing address

6101 Glenbrook LN W
Indian Head Park, IL 60525-6998
Phone (956) 832-3196

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20220726002613 IN Practitioner - Dentist 3274803739 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Northshore Health Centers Inc Current Accepting new patients
Northshore Health Centers, Inc. CurrentSince Jun 3, 2024 Accepting new patients
Northshore Health Centers, Inc. General Practice CurrentSince Jun 3, 2024 Accepting new patients
Community Healthnet Inc CurrentSince Jun 5, 2022 Accepting new patients
Community Healthnet Inc CurrentSince Jun 5, 2022 Accepting new patients
Community Healthnet Inc Past Accepting new patients

Locations

1021 W 5th Ave
Gary, IN 46402

3503 Martin Luther King Dr
Gary, IN 46409
Phone (219) 293-8843

6091 Broadway
Merrillville, IN 46410
Phone (219) 763-8944

6050 Sterling Creek Rd
Portage, IN 46368
Phone (219) 212-0188

Interoperability endpoints

  • Direct secure messaging: hector.trevino.p1@direct.northshorehealth.nextgenshare.com

Organizations & group practices 6

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": "1471305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471305600000",
    "number": "1306391719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6101 GLENBROOK LN W",
            "city": "INDIAN HEAD PARK",
            "state": "IL",
            "postal_code": "605256998",
            "telephone_number": "956-832-3196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2780 FM 365",
            "city": "PORT ARTHUR",
            "state": "TX",
            "postal_code": "77640",
            "telephone_number": "409-433-9254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TREVINO",
        "first_name": "HECTOR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-16",
        "last_updated": "2016-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "31910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Arthur, TX

Sources for this page

Verify at the official NPI Registry.