Individual provider Active NPI

Tricia Mae Cueva, DMD

  • Dentist
  • Wichita Falls, TX
National Provider Identifier
1659800720
Registry record updated Sep 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
32946 Issued in TX
Practice address
200 MLK Jr Blvd
Wichita Falls, TX 76301-1152
Phone
(940) 766-6306
NPI assigned
Jun 12, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 7052 NV
General Practice Dentistry 1223G0001X 32946 TX
Dentist 122300000X 32946 TX Primary

Addresses

Primary practice location

200 MLK Jr Blvd
Wichita Falls, TX 76301-1152

Mailing address

200 MLK Jr Blvd
Wichita Falls, TX 76301-1152
Phone (940) 766-6306

Other practice location 1

1208 E Bethany Dr Ste 7
Allen, TX 75002-3683
Phone (972) 390-8500

Other practice location 2

4117 S Staples St Ste 300
Corpus Christi, TX 78411-0012
Phone (361) 850-8000

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
I20240930002674 TX Order and Referring Only - DentistPractitioner - Dentist 3072044148

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7052NVMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Acdental Center, PLLC Dentist CurrentSince Jul 28, 2019 Accepting new patients
Bethany Heights Dental Care PLLC General Practice PastSince Apr 1, 2022 Accepting new patients

Locations

4117 S Staples St
Ste 300
Corpus Christi, TX 78411
Phone (361) 850-8000

Organizations & group practices 2

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": "1497225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726444800000",
    "number": "1659800720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MLK JR BLVD",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763011152",
            "telephone_number": "940-766-6306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MLK JR BLVD",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763011152",
            "telephone_number": "940-766-6306"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1208 E Bethany Dr Ste 7",
            "address_purpose": "LOCATION",
            "city": "Allen",
            "state": "TX",
            "postal_code": "750023683",
            "country_code": "US",
            "telephone_number": "972-390-8500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4117 S Staples St Ste 300",
            "address_purpose": "LOCATION",
            "city": "Corpus Christi",
            "state": "TX",
            "postal_code": "784110012",
            "country_code": "US",
            "telephone_number": "361-850-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CUEVA",
        "first_name": "TRICIA MAE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-12",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NV",
            "license": "7052",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "32946",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "32946",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita Falls, TX

Sources for this page

Verify at the official NPI Registry.