Vanesa G Clements DDS PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

24025 Issued in TX

Legal business name

VANESA G CLEMENTS DDS PC

Practice address

2200 Boca Chica Blvd
#138
Brownsville, TX 78521-2212

Phone

(956) 986-2222

Fax

(956) 986-2223

NPI assigned

Jul 20, 2015

Organization subpart

No

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

Authorized official

Name

Joseph W Clements

Title

Office Manager

Phone

(956) 986-2222

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Legacy Dental Doing business as

Locations

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

{
    "created_epoch": "1437350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437350400000",
    "number": "1336523364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 BOCA CHICA BLVD",
            "address_2": "#138",
            "city": "BROWNSVILLE",
            "state": "TX",
            "postal_code": "785212212",
            "telephone_number": "956-986-2222",
            "fax_number": "956-986-2223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 BOCA CHICA BLVD",
            "address_2": "#138",
            "city": "BROWNSVILLE",
            "state": "TX",
            "postal_code": "785212212",
            "telephone_number": "956-986-2222",
            "fax_number": "956-986-2223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VANESA G CLEMENTS DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-20",
        "last_updated": "2015-07-20",
        "status": "A",
        "authorized_official_last_name": "CLEMENTS",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "956-986-2222"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "24025",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "193080207",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1700047271",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Legacy Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Dentistry in Brownsville, TX
• Providers in Brownsville, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2015; 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.