Individual provider Active NPI

Lillian Adame Nelson, D.D.S.

  • General Practice Dentistry
  • Brownsville, TX
National Provider Identifier
1619988342
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
18988 Issued in TX
Practice address
925 E Los Ebanos Blvd
Brownsville, TX 78520-8726
Phone
(956) 542-1177
Fax
(956) 542-0033
NPI assigned
Aug 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 18988 TX Primary

Addresses

Primary practice location

925 E Los Ebanos Blvd
Brownsville, TX 78520-8726

Mailing address

925 E Los Ebanos Blvd
Brownsville, TX 78520-8726
Phone (956) 542-1177

Other identifiers 4

IdentifierTypeStateIssuer
B18988-02OtherTXCHIP LOS FRESNOS
89D288OtherTXBC/BS
1810147OtherTXUNITED CONCORDIA
B18988-01OtherTXBROWNSVILLE

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
I20160526000736 TX Order and Referring Only - DentistPractitioner - Dentist 2769772102

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18988TXMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Los Ebanos Family Dentistry General Practice Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1619988342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 E LOS EBANOS BLVD",
            "city": "BROWNSVILLE",
            "state": "TX",
            "postal_code": "785208726",
            "telephone_number": "956-542-1177",
            "fax_number": "956-542-0033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 E LOS EBANOS BLVD",
            "city": "BROWNSVILLE",
            "state": "TX",
            "postal_code": "785208726",
            "telephone_number": "956-542-1177",
            "fax_number": "956-542-0033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "LILLIAN",
        "middle_name": "ADAME",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-10",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "18988",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHIP LOS FRESNOS",
            "identifier": "B18988-02",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "89D288",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "1810147",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BROWNSVILLE",
            "identifier": "B18988-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brownsville, TX

Sources for this page

Verify at the official NPI Registry.