Courtni Nicole Tello, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

35257 Issued in TX

Practice address

1130 14TH St N
Texas City, TX 77590-5413

Phone

(409) 256-4896

NPI assigned

Jul 1, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1561939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561939200000",
    "number": "1487216495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "616 WHITE IBIS AVE",
            "city": "TEXAS CITY",
            "state": "TX",
            "postal_code": "775904242",
            "telephone_number": "409-256-4896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 14TH ST N",
            "city": "TEXAS CITY",
            "state": "TX",
            "postal_code": "775905413",
            "telephone_number": "409-256-4896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TELLO",
        "first_name": "COURTNI",
        "middle_name": "NICOLE",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-01",
        "last_updated": "2019-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "35257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "courtnitello@comcast.net",
            "affiliation": "N",
            "endpointDescription": "Dental Office",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1130 14th St N",
            "city": "Texas City",
            "state": "TX",
            "country_code": "US",
            "postal_code": "775905413",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• General Practice Dentistry in Texas City, TX
• Providers in Texas City, 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 Jul 1, 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.