Jo-Ann V Collantes, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

27822 Issued in TX

Practice address

125 W Park Ave
Hereford, TX 79045-4201

Phone

(806) 364-7688

Fax

(806) 364-7694

NPI assigned

Feb 7, 2012

Last updated

Jan 28, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1328572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390867200000",
    "number": "1508138496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 W PARK AVE",
            "city": "HEREFORD",
            "state": "TX",
            "postal_code": "790454201",
            "telephone_number": "806-364-7688",
            "fax_number": "806-364-7694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 W PARK AVE",
            "city": "HEREFORD",
            "state": "TX",
            "postal_code": "790454201",
            "telephone_number": "806-364-7688",
            "fax_number": "806-364-7694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLANTES",
        "first_name": "JO-ANN",
        "middle_name": "V",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-07",
        "last_updated": "2014-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "27822",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• CVS Pharmacy Inc (CVS Pharmacy # 07818)
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• David J Purdy DDS, PC

• General Practice Dentistry in Hereford, TX
• Providers in Hereford, 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 Jan 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.