Andes Dental PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

ANDES DENTAL PLLC

Practice address

1157 E 42ND St Ste a
Odessa, TX 79762-7723

Phone

(432) 242-6666

Fax

(832) 379-5175

NPI assigned

Sep 20, 2017

Organization subpart

No

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

Authorized official

Name

Keerthi Miryala, DMDNPI 1437247897

Title

Member

Phone

(832) 762-1914

Specialties & licenses 1

Addresses

Other names 1

• ODESSA FAMILY DENTAL Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Keerthi K Miryala, DMD

  • General Practice Dentistry
  • Odessa, TX
  • NPI 1437247897
  NPD Authorized official

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

{
    "created_epoch": "1505865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717459200000",
    "number": "1346759487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1157 E 42ND ST STE A",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797627723",
            "telephone_number": "432-242-6666",
            "fax_number": "832-379-5175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1157 E 42ND ST STE A",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797627723",
            "telephone_number": "432-242-6666",
            "fax_number": "832-379-5175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDES DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-20",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A",
        "authorized_official_last_name": "MIRYALA",
        "authorized_official_first_name": "KEERTHI",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "832-762-1914",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ODESSA FAMILY DENTAL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Belinda Sue Anderson, PTA
• Brooke Hannah Anderson
• Charlotte Anderson
• Errol Claude Anderson, M.D.
• Wesley Dale Anderson, L.S.A.
• Gregory Aaron Andis, M.S., LAT, ATC, PTA
• Grace Castillo Andrade, PA-C
• Liliana Coromoto Andrade, MD
• Obianuju Mercy Anelo
• Dimitrios Angelis, M.D

• General Practice Dentistry in Odessa, TX
• Providers in Odessa, 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 Jun 4, 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.

Verify at the official NPI Registry.