Active NPI
Raquel Pacheco Wright, DMD
- Dentist
- Dallas, TX
National Provider Identifier
1700082419
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 23761
- Practice address
- 3910 Gaston Ave Ste 175
Dallas, TX 75246-1504 - Phone
- (214) 257-1082
- Fax
- (214) 823-2326
- NPI assigned
- Jun 21, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 | 23761 | TX | Primary |
Addresses
Primary practice location
3910 Gaston Ave Ste 175
Dallas, TX 75246-1504
Mailing address
PO Box 1168
Anniston, AL 36202-1168
Phone (256) 241-7340
Other practice location 1
2530 S Buckner Blvd
Dallas, TX 75227-8548
Phone (972) 616-0060
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170426002524 | TX | Order and Referring Only - Dentist | 2264719343 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23761 | TX | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1182384000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1700082419",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1168",
"city": "ANNISTON",
"state": "AL",
"postal_code": "362021168",
"telephone_number": "256-241-7340",
"fax_number": "256-241-7373"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3910 GASTON AVE STE 175",
"city": "DALLAS",
"state": "TX",
"postal_code": "752461504",
"telephone_number": "214-257-1082",
"fax_number": "214-823-2326"
}
],
"practiceLocations": [
{
"address_1": "2530 S Buckner Blvd",
"address_purpose": "LOCATION",
"city": "Dallas",
"state": "TX",
"postal_code": "752278548",
"country_code": "US",
"telephone_number": "972-616-0060",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WRIGHT",
"first_name": "RAQUEL",
"middle_name": "PACHECO",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-06-21",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "23761",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.