Individual provider Active NPI

Arturo Davalos

  • General Practice Dentistry
  • Hugo, OK
National Provider Identifier
1609234822
Registry record updated Aug 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
0401415212 Issued in VA
Practice address
410 N M St
Hugo, OK 74743
Phone
(580) 326-7561
NPI assigned
Feb 2, 2016
Last updated
Aug 21, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 21, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 0401415212 VA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

410 N M St
Hugo, OK 74743

Mailing address

410 N M St
Hugo, OK 74743-1820
Phone (580) 326-7561

Other practice location 1

700 S Ochoa St
El Paso, TX 79901-2936
Phone (915) 231-4386

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20170110001007 TX Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 7214218056

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0401415212VAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1454371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566345600000",
    "number": "1609234822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 N M ST",
            "city": "HUGO",
            "state": "OK",
            "postal_code": "747431820",
            "telephone_number": "580-326-7561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 N M ST",
            "city": "HUGO",
            "state": "OK",
            "postal_code": "74743",
            "telephone_number": "580-326-7561"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "700 S Ochoa St",
            "address_purpose": "LOCATION",
            "city": "El Paso",
            "state": "TX",
            "postal_code": "799012936",
            "country_code": "US",
            "telephone_number": "915-231-4386",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVALOS",
        "first_name": "ARTURO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-02-02",
        "last_updated": "2019-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401415212",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hugo, OK

Sources for this page

Verify at the official NPI Registry.