Active NPI
Claudio Herman Caycedo, D.D.S.
- General Practice Dentistry
- Waco, TX
National Provider Identifier
1306965736
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 19706
- Practice address
- 4215 Franklin Ave
Waco, TX 76710-2529 - Phone
- (254) 227-6444
- NPI assigned
- Mar 28, 2007
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 2385 | NM | |
| General Practice Dentistry | 1223G0001X | 19706 | TX | Primary |
Addresses
Primary practice location
4215 Franklin Ave
Waco, TX 76710-2529
Mailing address
3901 Benetton Way
Leander, TX 78641-5034
Phone (806) 778-8826
Other practice location 1
111 W Clinton St
Hobbs, NM 88240-8201
Phone (505) 393-6047
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 912186110 | Other | NM | DORAL DENTAL - MEDICAID |
| 44425864 | Medicaid | NM | |
| 01584804 | Other | UNITED CONCORDIA |
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 |
|---|---|---|---|
| 19706 | TX | MD | General Practice Dentistry |
| 2385 | NM | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175040000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1732579200000",
"number": "1306965736",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3901 BENETTON WAY",
"city": "LEANDER",
"state": "TX",
"postal_code": "786415034",
"telephone_number": "806-778-8826"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4215 FRANKLIN AVE",
"city": "WACO",
"state": "TX",
"postal_code": "767102529",
"telephone_number": "254-227-6444"
}
],
"practiceLocations": [
{
"address_1": "111 W Clinton St",
"address_purpose": "LOCATION",
"city": "Hobbs",
"state": "NM",
"postal_code": "882408201",
"country_code": "US",
"telephone_number": "505-393-6047",
"fax_number": "505-397-2999",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CAYCEDO",
"first_name": "CLAUDIO",
"middle_name": "HERMAN",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-28",
"last_updated": "2024-11-26",
"certification_date": "2024-11-26",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NM",
"license": "2385",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "19706",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DORAL DENTAL - MEDICAID",
"identifier": "912186110",
"state": "NM"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "44425864",
"state": "NM"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED CONCORDIA",
"identifier": "01584804",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Waco, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.