Individual provider Active NPI

Rodnel Jean Eldor

  • Dental Assistant
  • Fort Bliss, TX
National Provider Identifier
1528572666
Registry record updated Nov 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental AssistantTaxonomy code 126800000X
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, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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.

Verify at the official NPI Registry.