Individual provider Active NPI

Roxana Hurtado, DMD

  • General Practice Dentistry
  • El Paso, TX
National Provider Identifier
1659920759
Registry record updated May 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
35713 Issued in TX
Practice address
4875 Maxwell Ave
El Paso, TX 79904-1559
Phone
(915) 465-0810
NPI assigned
Sep 11, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2022

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 35713 TX Primary

Addresses

Primary practice location

4875 Maxwell Ave
El Paso, TX 79904-1559

Mailing address

4875 Maxwell Ave
El Paso, TX 79904-1559

Other identifiers 1

IdentifierTypeStateIssuer
35713OtherTXTX LICENSE

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
I20191008000056 TX Practitioner - Dentist 8729319629

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
35713TXMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1568160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652745600000",
    "number": "1659920759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4875 MAXWELL AVE",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799041559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4875 MAXWELL AVE",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799041559",
            "telephone_number": "915-465-0810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HURTADO",
        "first_name": "ROXANA",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-11",
        "last_updated": "2022-05-17",
        "certification_date": "2022-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "35713",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TX LICENSE",
            "identifier": "35713",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

Verify at the official NPI Registry.