Ulysses Dental Group, PA

Primary specialty

DentistTaxonomy code 122300000X

License

18068 Issued in TX

Legal business name

ULYSSES DENTAL GROUP, PA

Practice address

4626 S Closner Blvd
Edinburg, TX 78539-7279

Phone

(956) 537-9933

Fax

(956) 618-3118

NPI assigned

Mar 13, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Jose Villarreal Sr., DDS

Title

President

Phone

(956) 537-9933

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1331596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331596800000",
    "number": "1437424280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4626 S CLOSNER BLVD",
            "city": "EDINBURG",
            "state": "TX",
            "postal_code": "785397279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4626 S CLOSNER BLVD",
            "city": "EDINBURG",
            "state": "TX",
            "postal_code": "785397279",
            "telephone_number": "956-537-9933",
            "fax_number": "956-618-3118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ULYSSES DENTAL GROUP, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-13",
        "last_updated": "2012-03-13",
        "status": "A",
        "authorized_official_last_name": "VILLARREAL",
        "authorized_official_first_name": "JOSE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "956-537-9933",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "TX",
            "license": "18068",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2012; 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.