Organization Active NPI

Mountain Smiles - Burleson PLLC

  • Dentist
  • Burleson, TX
National Provider Identifier
1346145984
Registry record updated Oct 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
MOUNTAIN SMILES - BURLESON PLLC
Practice address
2701 SW Wilshire Blvd
Burleson, TX 76028-6307
Phone
(817) 295-2031
NPI assigned
Oct 13, 2026
Last updated
Oct 13, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2026

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

Authorized official

Name
Angel Gimenez
Title
Credentialing Manager
Phone
(719) 300-5933

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

2701 SW Wilshire Blvd
Burleson, TX 76028-6307

Mailing address

2701 SW Wilshire Blvd
Burleson, TX 76028-6307
Phone (817) 295-2031

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1791849600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1791849600000",
    "number": "1346145984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 SW WILSHIRE BLVD",
            "city": "BURLESON",
            "state": "TX",
            "postal_code": "760286307",
            "telephone_number": "817-295-2031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 SW WILSHIRE BLVD",
            "city": "BURLESON",
            "state": "TX",
            "postal_code": "760286307",
            "telephone_number": "817-295-2031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN SMILES - BURLESON PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-10-13",
        "last_updated": "2026-10-13",
        "certification_date": "2026-10-13",
        "status": "A",
        "authorized_official_last_name": "GIMENEZ",
        "authorized_official_first_name": "ANGEL",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "719-300-5933"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burleson, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2026; 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.