Individual provider Active NPI

Antonio Berto Botella, D.D.S.

  • Endodontics
  • Plano, TX
National Provider Identifier
1760740518
Registry record updated May 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
25376 Issued in TX
Practice address
5800 Coit Rd
Plano, TX 75023-5942
Phone
(972) 596-9400
NPI assigned
Apr 30, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 25376 TX Primary

Addresses

Primary practice location

5800 Coit Rd
Plano, TX 75023-5942

Mailing address

6934 Midbury Dr
Dallas, TX 75230-3130
Phone (214) 457-9281

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
I20150312000190 TX Order and Referring Only - DentistPractitioner - Dentist 3779809645

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
25376TXMDClinical Neuropsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Mercedes S Dominguez, DDS, Ms, PA Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1335744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778025600000",
    "number": "1760740518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6934 MIDBURY DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752303130",
            "telephone_number": "214-457-9281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5800 COIT RD",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750235942",
            "telephone_number": "972-596-9400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERTO BOTELLA",
        "first_name": "ANTONIO",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-30",
        "last_updated": "2026-05-06",
        "certification_date": "2026-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "TX",
            "license": "25376",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

Verify at the official NPI Registry.