Amanda Christine Griego Pelletier, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

35132 Issued in TX

Practice address

1050 Sunland Park Dr # B200
El Paso, TX 79922-1326

Phone

(915) 213-1200

NPI assigned

May 1, 2019

Last updated

May 13, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Mandy C Griego Pelletier Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Nov 28, 2022 through Nov 28, 2026

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Smile Center for Kids I PLLC

  • General Practice Dentistry
  • El Paso, TX
  • NPI 1689072233
  NPD (past)

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

{
    "created_epoch": "1556668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715558400000",
    "number": "1710542196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 LOS PINOS WAY",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799121850",
            "telephone_number": "915-526-9861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 SUNLAND PARK DR # B200",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799221326",
            "telephone_number": "915-213-1200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12801 Edgemere Blvd # 112",
            "address_purpose": "LOCATION",
            "city": "El Paso",
            "state": "TX",
            "postal_code": "799389500",
            "country_code": "US",
            "telephone_number": "915-493-6310",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRIEGO PELLETIER",
        "first_name": "AMANDA",
        "middle_name": "CHRISTINE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-01",
        "last_updated": "2024-05-13",
        "certification_date": "2024-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "35132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MANDY",
            "last_name": "GRIEGO PELLETIER",
            "middle_name": "C",
            "prefix": "DR.",
            "credential": "DDS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Charles Gregory
• John Kennedy Gresham, M.D.
• Jennifer Grew
• Navtej Singh Grewal, MD
• Sean Grewal
• Annette Griego, NP
• Mallory Griego
• Neil Anthony Grieshop, M.D.
• Myron Griffin, CPO, LPO
• Samuel J Griffin

• General Practice Dentistry in El Paso, TX
• Providers in El Paso, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.