Organization Active NPI

Octavio Mejia Jr DDS

  • Dentist
  • Mission, TX
National Provider Identifier
1679643415
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
19615 Issued in TX
Legal business name
OCTAVIO MEJIA JR DDS
Practice address
2103 E Griffin Parkway
Suite a
Mission, TX 78572
Phone
(956) 583-9880
Fax
(956) 583-1383
NPI assigned
Nov 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Octavio Mejia Jr., DDSNPI 1689831406
Title
Owner
Phone
(956) 583-9880

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 19615 TX Primary

Addresses

Primary practice location

2103 E Griffin Parkway
Suite a
Mission, TX 78572

Mailing address

2103 E Griffin Parkway
Suite a
Mission, TX 78572
Phone (956) 583-9880

Other identifiers 1

IdentifierTypeStateIssuer
B19615OtherCHIP

National Provider Directory

National Provider Directory

Locations

2103 E Griffin Pkwy
Ste A
Mission, TX 78572
Phone (956) 583-9880

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1679643415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2103 E GRIFFIN PARKWAY",
            "address_2": "SUITE A",
            "city": "MISSION",
            "state": "TX",
            "postal_code": "78572",
            "telephone_number": "956-583-9880",
            "fax_number": "956-583-1383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2103 E GRIFFIN PARKWAY",
            "address_2": "SUITE A",
            "city": "MISSION",
            "state": "TX",
            "postal_code": "78572",
            "telephone_number": "956-583-9880",
            "fax_number": "956-583-1383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OCTAVIO MEJIA JR DDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MEJIA",
        "authorized_official_first_name": "OCTAVIO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "956-583-9880",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "TX",
            "license": "19615",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHIP",
            "identifier": "B19615",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mission, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.