Individual provider Active NPI

Todd M. Parco, D.D.S.

  • Pediatric Dentistry
  • Las Cruces, NM
National Provider Identifier
1396737557
Registry record updated Oct 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
DD2445 Issued in NM
Practice address
1901 Calle de Ninos
Las Cruces, NM 88005-3293
Phone
(575) 526-5522
Fax
(575) 523-5312
NPI assigned
Aug 15, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 8306 CO
Pediatric Dentistry 1223P0221X DD2445 NM Primary
Pediatric Dentistry 1223P0221X 25762 TX

Addresses

Primary practice location

1901 Calle de Ninos
Las Cruces, NM 88005-3293

Mailing address

4435 Organ Mesa Loop
Las Cruces, NM 88011-8404
Phone (575) 526-5522

Other identifiers 3

IdentifierTypeStateIssuer
30259037MedicaidCO
31677592MedicaidNM
01316253OtherUNITED CONCORDIA

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

LicenseStateTypeSpecialty
8306COMDGeneral Practice Dentistry
DD2445NMMDPediatric Dentist
25762TXMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
The Croc Doc, P.C. Pediatric Dentistry Current Accepting new patients

Locations

1901 Calle de Ninos
Las Cruces, NM 88005
Phone (575) 523-5312

7878 Gateway Blvd E
Ste 101
El Paso, TX 79915
Phone (915) 444-5121

7878 Gateway Blvd E
Ste 100
El Paso, TX 79915

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1124064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383004800000",
    "number": "1396737557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4435 ORGAN MESA LOOP",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880118404",
            "telephone_number": "575-526-5522",
            "fax_number": "575-523-5312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 CALLE DE NINOS",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880053293",
            "telephone_number": "575-526-5522",
            "fax_number": "575-523-5312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARCO",
        "first_name": "TODD",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-15",
        "last_updated": "2013-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "8306",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NM",
            "license": "DD2445",
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TX",
            "license": "25762",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30259037",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31677592",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "01316253",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Cruces, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2013; 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.