Legacy Smiles Edinburg PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

LEGACY SMILES EDINBURG PLLC

Practice address

4626 S Closner Blvd
Edinburg, TX 78539-7279

Phone

(956) 475-3005

NPI assigned

Mar 28, 2025

Organization subpart

No

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

Authorized official

Name

Jerin Jacob

Title

Owner Dentist

Phone

(956) 574-4666

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1743120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743120000000",
    "number": "1477356228",
    "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",
            "telephone_number": "956-475-3005"
        },
        {
            "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": "956-475-3005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY SMILES EDINBURG PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-28",
        "last_updated": "2025-03-28",
        "certification_date": "2025-03-28",
        "status": "A",
        "authorized_official_last_name": "JACOB",
        "authorized_official_first_name": "JERIN",
        "authorized_official_title_or_position": "OWNER DENTIST",
        "authorized_official_telephone_number": "956-574-4666"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel C Lee, D.O.
• David Aubrey Lee, MD
• Maggie Wushuang Lee, MD
• Yuen Keung Lee, D.D.S.
• Lefleur Transportation of Texas, Inc.
• Andrew Jay Leija
• Brianna Leija, BT
• Yanet Leija, FNP-BC
• Gary Evan Leka, PH.D.
• Justin C Lemmo, DPT

• General Practice Dentistry in Edinburg, TX
• Providers in Edinburg, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2025; 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.