Rodeo Dental Pharr PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

24133 Issued in TX

Legal business name

RODEO DENTAL PHARR PLLC

Doing business as

Rodeo Dental

Practice address

1300 South Cage Blvd.
Ste. K
Pharr, TX 78577

Phone

(817) 624-6677

NPI assigned

Oct 4, 2011

Last updated

Oct 4, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Raffy Kouyoumdjian, D.M.D.

Title

Owner

Phone

(818) 653-9799

Specialties & licenses 3

Addresses

Other names 1

• Rodeo Dental Doing business as

Locations

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

{
    "created_epoch": "1317686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317686400000",
    "number": "1396029781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 SOUTH CAGE BLVD.",
            "address_2": "STE. K",
            "city": "PHARR",
            "state": "TX",
            "postal_code": "78577",
            "telephone_number": "817-624-6677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 SOUTH CAGE BLVD.",
            "address_2": "STE. K",
            "city": "PHARR",
            "state": "TX",
            "postal_code": "78577",
            "telephone_number": "817-624-6677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RODEO DENTAL PHARR PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-04",
        "last_updated": "2011-10-04",
        "status": "A",
        "authorized_official_last_name": "KOUYOUMDJIAN",
        "authorized_official_first_name": "RAFFY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "818-653-9799",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "TX",
            "license": "23066",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "24133",
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TX",
            "license": "21527",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rodeo Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Risas Y Rayones Homecare Services LLC
• Risas Y Rayones Rehab Services
• Bertha Irene Rivas, LCDC
• Ivan Jerick Rizal, OTR
• Roberto Diaz D.D.S. P.a. (Cosmetic and Esthetic Dental Center)
• Carmen Yomara Rodriguez Gonzalez, APRN
• Denisse Adriana Rodriguez Leos, COTA
• Alyza Rodriguez
• Dinorha Nennette Rodriguez, RN
• Elizabeth Rodriguez, COTA

• General Practice Dentistry in Pharr, TX
• Providers in Pharr, 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 Oct 4, 2011; 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.