Active NPI
Ingrid F Proenca-Afonso, D.D.S.
- Dentist
- Dallas, TX
National Provider Identifier
1407901903
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 23112
- Practice address
- 6031 Sherry LN
Dallas, TX 75225-6402 - Phone
- (214) 369-8585
- NPI assigned
- Jan 24, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Dentist | 122300000X | 23112 | TX | Primary |
Addresses
Primary practice location
6031 Sherry LN
Dallas, TX 75225-6402
Mailing address
1232 Waterdown Dr
Allen, TX 75013-5312
Phone (214) 509-0722
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150129001448 | TX | Order and Referring Only - Oral Surgery | 3173847860 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23112 | TX | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jacqueline M. Plemons, DDS, Ms | Past | Accepting new patients |
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.
-
- Periodontics
- Dallas, TX
- NPI 1417158809
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169596800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707091200000",
"number": "1407901903",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1232 WATERDOWN DR",
"city": "ALLEN",
"state": "TX",
"postal_code": "750135312",
"telephone_number": "214-509-0722"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6031 SHERRY LN",
"city": "DALLAS",
"state": "TX",
"postal_code": "752256402",
"telephone_number": "214-369-8585"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PROENCA-AFONSO",
"first_name": "INGRID",
"middle_name": "F",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-24",
"last_updated": "2024-02-05",
"certification_date": "2024-02-05",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "23112",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
- McKenzie Proctor, RBT
- Quinn Proctor
- Tianna Proctor
- Timothy James Proctor, PH.D.
- Productive Rehabilitation Institute of Dallas for Ergonomics
- Professional Care Facility
- Professional Diagnostic Affiliates
- Professional Nutrition Therapists, LLC
- Professional Vascular Diagnostics Inc.
- John Leslie Proffitt, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.