Active NPI
Antonio Martin Pacheco Jr., DDS
- General Practice Dentistry
- Austin, TX
National Provider Identifier
1497804611
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 18981
- Practice address
- 8500 Bluffstone CV Ste B203
Austin, TX 78759-7812 - Phone
- (512) 345-9229
- Fax
- (512) 231-0596
- NPI assigned
- Jan 9, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 18981 | TX | Primary |
Addresses
Primary practice location
8500 Bluffstone CV Ste B203
Austin, TX 78759-7812
Mailing address
8500 Bluffstone CV Ste B203
Austin, TX 78759-7812
Phone (512) 345-9229
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18981 | TX | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168300800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1497804611",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8500 BLUFFSTONE CV STE B203",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787597812",
"telephone_number": "512-345-9229",
"fax_number": "512-231-0596"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8500 BLUFFSTONE CV STE B203",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787597812",
"telephone_number": "512-345-9229",
"fax_number": "512-231-0596"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PACHECO",
"first_name": "ANTONIO",
"middle_name": "MARTIN",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-09",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "18981",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.