Rio Grande City Dental PLLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

RIO GRANDE CITY DENTAL PLLC

Doing business as

Rodeo Dental and Orthodontics

Practice address

4024 E. US Highway 83
Suite 100
Rio Grande City, TX 78582

Phone

(817) 529-8151

Fax

(817) 928-1681

NPI assigned

May 16, 2013

Organization subpart

No

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

Authorized official

Name

William Hailey Dunklin, DDS

Title

Owner

Phone

(817) 529-8151

Specialties & licenses 1

Addresses

Other identifiers 7

Other names 1

• Rodeo Dental and Orthodontics Doing business as

Locations

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

{
    "created_epoch": "1368662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666742400000",
    "number": "1316383482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E. 15TH ST.",
            "address_2": "SUITE 520",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761026566",
            "telephone_number": "817-529-8151",
            "fax_number": "817-925-1681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4024 E. US HIGHWAY 83",
            "address_2": "SUITE 100",
            "city": "RIO GRANDE CITY",
            "state": "TX",
            "postal_code": "78582",
            "telephone_number": "817-529-8151",
            "fax_number": "817-928-1681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIO GRANDE CITY DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-16",
        "last_updated": "2022-10-26",
        "certification_date": "2022-10-26",
        "status": "A",
        "authorized_official_last_name": "DUNKLIN",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "HAILEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-529-8151",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "168217115",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "168217117",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "168217118",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "168217112",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "168217116",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "168217113",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "168217114",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rodeo Dental and Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Maria Graciela Quintos Reyes, PT
• Robert Raymond Reyes, MD
• Reanna Renee Reyna, PA
• Rio DME LLC
• Rio Grande City Cisd
• Rio Grande City Pediatric Dentistry PLLC
• Rio Grande City Professional Counseling Services
• Rio Grande Pediatric Clinic
• Rio Grande Pediatric Clinic (Juan Aguilera and Associates)
• Rio Nutrition Consulting, LLC

• Dentist in Rio Grande City, TX
• Providers in Rio Grande City, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2022; 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.