Community Dental Outreach, PLLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

COMMUNITY DENTAL OUTREACH, PLLC

Practice address

3507 Jaime Zapata Memorial Hwy Ste 3
Laredo, TX 78043-4769

Phone

(972) 832-7825

NPI assigned

Jun 25, 2013

Organization subpart

No

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

Authorized official

Name

Bradley Richens, DDS

Title

Owner

Phone

(972) 832-7825

Specialties & licenses 1

Addresses

Other names 1

• Imagine Dental of South Laredo Doing business as

Locations

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

{
    "created_epoch": "1372118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372118400000",
    "number": "1447690276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3507 JAIME ZAPATA MEMORIAL HWY STE 3",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780434769",
            "telephone_number": "972-832-7825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3507 JAIME ZAPATA MEMORIAL HWY STE 3",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780434769",
            "telephone_number": "972-832-7825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY DENTAL OUTREACH, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-25",
        "last_updated": "2013-06-25",
        "status": "A",
        "authorized_official_last_name": "RICHENS",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "972-832-7825",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Imagine Dental of South Laredo",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Aisha Colchado, ASSISTANT SLP
• Stephanie Giselle Colon Cabot, BS, DC
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• Community Action Corporation of South Texas
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• Rene Compean II, MD
• Rene R Compean, MD
• Complete Choice Care, Inc
• Amparo Luisa Compt0N, R.PH.

• All providers in Laredo, TX
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 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.