NPIMap

Organization Active NPI

Pellicano Family Dentistry PLLC

  • Dental Clinic/Center
  • El Paso, TX
National Provider Identifier
1407413594
Registry record updated May 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
PELLICANO FAMILY DENTISTRY PLLC
Practice address
11615 Pellicano Dr # 100
El Paso, TX 79936-6242
Phone
(915) 444-8006
NPI assigned
May 23, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 23, 2019

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

Authorized official

Name
Lupita Mendoza
Title
Office Manager
Phone
(214) 616-6148

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

11615 Pellicano Dr # 100
El Paso, TX 79936-6242

Mailing address

11615 Pellicano Dr # 100
El Paso, TX 79936-6242
Phone (915) 444-8006

National Provider Directory

National Provider Directory

Locations

11615 Pellicano Dr
#100
El Paso, TX 79936
Phone (915) 444-8006

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1558569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1558569600000",
    "number": "1407413594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11615 PELLICANO DR # 100",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799366242",
            "telephone_number": "915-444-8006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11615 PELLICANO DR # 100",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799366242",
            "telephone_number": "915-444-8006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PELLICANO FAMILY DENTISTRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-23",
        "last_updated": "2019-05-23",
        "status": "A",
        "authorized_official_last_name": "MENDOZA",
        "authorized_official_first_name": "LUPITA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "214-616-6148"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2019; 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.