NPIMap

Organization Active NPI

Agave Dental Care East PLLC

  • General Practice Dentistry
  • El Paso, TX
National Provider Identifier
1508505140
Registry record updated Jun 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
AGAVE DENTAL CARE EAST PLLC
Practice address
1806 McRae Blvd
El Paso, TX 79925-6706
Phone
(915) 591-7117
NPI assigned
Jun 1, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2022

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

Authorized official

Name
Joseph Alexander Havig, DMDNPI 1891355202
Title
Manager
Phone
(480) 284-1338

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

1806 McRae Blvd
El Paso, TX 79925-6706

Mailing address

1806 McRae Blvd
El Paso, TX 79925-6706
Phone (915) 591-7117

National Provider Directory

National Provider Directory

Locations

1806 McRae Blvd
El Paso, TX 79925
Phone (915) 591-7117

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1654041600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654041600000",
    "number": "1508505140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1806 MCRAE BLVD",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799256706",
            "telephone_number": "915-591-7117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1806 MCRAE BLVD",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799256706",
            "telephone_number": "915-591-7117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGAVE DENTAL CARE EAST PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-01",
        "last_updated": "2022-06-01",
        "certification_date": "2022-06-01",
        "status": "A",
        "authorized_official_last_name": "HAVIG",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "ALEXANDER",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "480-284-1338",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2022; 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.