Active NPI
Rodnel Jean Eldor
- Dental Assistant
- Fort Bliss, TX
National Provider Identifier
1528572666
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Assistant
- Practice address
- US Army Dental Health Activity
BLD 128, Chaffee Rd
Fort Bliss, TX 79916 - Phone
- (915) 742-6001
- NPI assigned
- Nov 28, 2017
- Last updated
- Nov 28, 2017
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Dental Assistant | 126800000X | Primary |
Addresses
Primary practice location
US Army Dental Health Activity
BLD 128, Chaffee Rd
Fort Bliss, TX 79916
Mailing address
US Army Dental Health Activity
BLD 128, Chaffee Rd
Fort Bliss, TX 79916
Phone (915) 742-6001
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1511827200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1511827200000",
"number": "1528572666",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "US ARMY DENTAL HEALTH ACTIVITY",
"address_2": "BLD 128, CHAFFEE RD",
"city": "FORT BLISS",
"state": "TX",
"postal_code": "79916",
"telephone_number": "915-742-6001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "US ARMY DENTAL HEALTH ACTIVITY",
"address_2": "BLD 128, CHAFFEE RD",
"city": "FORT BLISS",
"state": "TX",
"postal_code": "79916",
"telephone_number": "915-742-6001"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELDOR",
"first_name": "RODNEL JEAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-11-28",
"last_updated": "2017-11-28",
"status": "A"
},
"taxonomies": [
{
"code": "126800000X",
"taxonomy_group": "",
"desc": "Dental Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fort Bliss, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.