Individual provider Active NPI

Kassiley Adriane De Faria, DDS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Laredo, TX
National Provider Identifier
1639004633
Registry record updated Sep 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
42965 Issued in TX
Practice address
910 Guadalupe St Ste a
Laredo, TX 78040-5280
Phone
(956) 884-4840
NPI assigned
Jun 12, 2026
Last updated
Sep 21, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 42965 TX Primary

Addresses

Primary practice location

910 Guadalupe St Ste a
Laredo, TX 78040-5280

Mailing address

1632 Wildwood Rd
Marietta, GA 30062-4051
Phone (678) 431-8110

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

State licenses

LicenseStateTypeSpecialty
42965TXMDOrthodontics and Dentofacial Orthopedic Dentist

NPI Registry JSON

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

{
    "created_epoch": "1781222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789948800000",
    "number": "1639004633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1632 WILDWOOD RD",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300624051",
            "telephone_number": "678-431-8110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 GUADALUPE ST STE A",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780405280",
            "telephone_number": "956-884-4840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE FARIA",
        "first_name": "KASSILEY",
        "middle_name": "ADRIANE",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-06-12",
        "last_updated": "2026-09-21",
        "certification_date": "2026-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "TX",
            "license": "42965",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laredo, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2026; 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.