Organization Active NPI

El Paso Dental Care

  • General Practice Dentistry
  • El Paso, TX
National Provider Identifier
1740308568
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
13460 Issued in TX
Legal business name
EL PASO DENTAL CARE
Practice address
11625 Pellicano Dr
El Paso, TX 79936-6242
Phone
(915) 855-8484
Fax
(915) 855-1819
NPI assigned
Mar 27, 2007
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
Ms. Therese A. Gutierrez
Title
Office Manager
Phone
(915) 855-8484

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 13460 TX Primary

Addresses

Primary practice location

11625 Pellicano Dr
El Paso, TX 79936-6242

Mailing address

11625 Pellicano Dr
El Paso, TX 79936-6242
Phone (915) 855-8484

National Provider Directory

National Provider Directory

Locations

11625 Pellicano Dr
El Paso, TX 79936
Phone (915) 855-8484

Practitioners & affiliated clinicians

Practitioners 2

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": "1174953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1740308568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11625 PELLICANO DR",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799366242",
            "telephone_number": "915-855-8484",
            "fax_number": "915-855-1819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11625 PELLICANO DR",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799366242",
            "telephone_number": "915-855-8484",
            "fax_number": "915-855-1819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EL PASO DENTAL CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GUTIERREZ",
        "authorized_official_first_name": "THERESE",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "915-855-8484",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "13460",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, 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.