Active NPI
Winona Shawn Trevino, DDS
- General Practice Dentistry
- Pharr, TX
National Provider Identifier
1326112319
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 19469
- Practice address
- 413 W Sam Houston Blvd
Pharr, TX 78577-5349 - Phone
- (956) 781-8880
- Fax
- (956) 781-8977
- NPI assigned
- Nov 20, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 19469 | TX | Primary |
Addresses
Primary practice location
413 W Sam Houston Blvd
Pharr, TX 78577-5349
Mailing address
413 W Sam Houston Blvd
Pharr, TX 78577-5349
Phone (956) 781-8880
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 037347403 | Medicaid | TX |
Other names 1
- Ms. Winona Shawn Moczygemba
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 |
|---|---|---|---|
| 19469 | TX | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rio Grande Valley Children'S Dentistry | General Practice | 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 and National Provider Directory roles.
-
- Pediatric Dentistry
- Pharr, TX
- NPI 1093897951
General Practice
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163980800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1279152000000",
"number": "1326112319",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "413 W SAM HOUSTON BLVD",
"city": "PHARR",
"state": "TX",
"postal_code": "785775349",
"telephone_number": "956-781-8880",
"fax_number": "956-781-8977"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "413 W SAM HOUSTON BLVD",
"city": "PHARR",
"state": "TX",
"postal_code": "785775349",
"telephone_number": "956-781-8880",
"fax_number": "956-781-8977"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TREVINO",
"first_name": "WINONA",
"middle_name": "SHAWN",
"name_prefix": "Mrs.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-20",
"last_updated": "2010-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "19469",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "037347403",
"state": "TX"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "WINONA",
"last_name": "MOCZYGEMBA",
"middle_name": "SHAWN",
"prefix": "MS.",
"credential": "DDS",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Pharr, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.