Carlos Gabriel Landaeta Quinones, D.D.S.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

30389 Issued in TX

Practice address

4502 Medical Dr
San Antonio, TX 78229-4402

Phone

(210) 567-3460

NPI assigned

Jul 31, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: clandaetaquinones59824@direct.utmsa.com

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.

• University of Texas Health Science Center at San Antonio

  • Internal Medicine Physician
  • San Antonio, TX
  • NPI 1720051717
  Medicare reassignment NPD
• The University of Texas Health Science Center at San Antonio

  • General Acute Care Hospital
  • San Antonio, TX
  • NPI 1326829904
  NPD
• University of Texas Health Science Center at San Antonio

  • Diagnostic Radiology Physician
  • Boerne, TX
  • NPI 1417921834
  NPD

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

{
    "created_epoch": "1375228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475539200000",
    "number": "1770915829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7703 FLOYD CURL DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293901",
            "telephone_number": "210-567-3297",
            "fax_number": "210-567-6600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4502 MEDICAL DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782294402",
            "telephone_number": "210-567-3460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDAETA QUINONES",
        "first_name": "CARLOS",
        "middle_name": "GABRIEL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-31",
        "last_updated": "2016-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "30389",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Briana M Lancerio, RBT
• Lynda Lancharic
• Jorge Humberto Landa Jr., CSFA
• Paul Landa
• Robyn Landa, LVN
• Carmen Elena Landaverde, M.D.
• Jennifer Renee Landaverde, RPH
• James M Landeen, MD
• Aisha Landeros, PHARMD
• Christina Renee Landeros, LCSW

• Oral and Maxillofacial Surgery (Dentist) in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Oral and Maxillofacial Surgery (Dentist) in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2016; 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.

Verify at the official NPI Registry.