Active NPI
Jorge A Villanueva, DDS
- General Practice Dentistry
- Dallas, TX
National Provider Identifier
1376083808
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 32691
- Practice address
- 329 E Colorado Blvd Apt 705
Dallas, TX 75203-1257 - Phone
- (469) 585-0755
- NPI assigned
- Mar 2, 2017
- Sex
- Male
- 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 | 32691 | TX | Primary |
Addresses
Primary practice location
329 E Colorado Blvd Apt 705
Dallas, TX 75203-1257
Mailing address
329 E Colorado Blvd Apt 705
Dallas, TX 75203-1257
Phone (469) 585-0755
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 |
|---|---|---|---|
| 32691 | TX | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1488412800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1580860800000",
"number": "1376083808",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "329 E COLORADO BLVD APT 705",
"city": "DALLAS",
"state": "TX",
"postal_code": "752031257",
"telephone_number": "469-585-0755"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "329 E COLORADO BLVD APT 705",
"city": "DALLAS",
"state": "TX",
"postal_code": "752031257",
"telephone_number": "469-585-0755"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VILLANUEVA",
"first_name": "JORGE",
"middle_name": "A",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-03-02",
"last_updated": "2020-02-05",
"certification_date": "2020-02-05",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "32691",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.