Active NPI
Kristen Mercedes Estrada, D.D.S
- Dentist
- El Paso, TX
National Provider Identifier
1659672145
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 25686
- Practice address
- 315 Alvarez Dr
El Paso, TX 79932-1405 - Phone
- (575) 571-3745
- NPI assigned
- Nov 15, 2010
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 25686 | TX | Primary |
Addresses
Primary practice location
315 Alvarez Dr
El Paso, TX 79932-1405
Mailing address
315 Alvarez Dr
El Paso, TX 79932-1405
Phone (575) 571-3745
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130528000348 | IL | Order and Referring Only - Oral Surgery | 0840438123 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25686 | TX | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1289779200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1289779200000",
"number": "1659672145",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "315 ALVAREZ DR",
"city": "EL PASO",
"state": "TX",
"postal_code": "799321405",
"telephone_number": "575-571-3745"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "315 ALVAREZ DR",
"city": "EL PASO",
"state": "TX",
"postal_code": "799321405",
"telephone_number": "575-571-3745"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ESTRADA",
"first_name": "KRISTEN",
"middle_name": "MERCEDES",
"credential": "D.D.S",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-11-15",
"last_updated": "2010-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "25686",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in El Paso, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.