Emma L Gavito, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

13875 Issued in TX

Practice address

4912 Padre Blvd
South Padre Island, TX 78597-7343

Phone

(956) 761-1012

Fax

(956) 761-4447

NPI assigned

Oct 3, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1811081680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4912 PADRE BLVD",
            "city": "SOUTH PADRE ISLAND",
            "state": "TX",
            "postal_code": "785977343",
            "telephone_number": "956-761-1012",
            "fax_number": "956-761-4447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4912 PADRE BLVD",
            "city": "SOUTH PADRE ISLAND",
            "state": "TX",
            "postal_code": "785977343",
            "telephone_number": "956-761-1012",
            "fax_number": "956-761-4447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAVITO",
        "first_name": "EMMA",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "13875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• CVS Pharmacy Inc (CVS Pharmacy #05641)
• Richard Bruce Debenedetto, M.D.
• Emergence Medicine PA
• Brad Fitch
• Isela Flores, FNP
• Clarissa Gonzalez
• Melva Hager, SLPA
• Harlingen Medical Center Limited Partnership (Family Wellness Clinic at SPI)
• Nina Grena Herring, FNP-C, PMHNP-B
• Joan T Hovland, LCSW, LCDC

• General Practice Dentistry in South Padre Island, TX
• Providers in South Padre Island, 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 Jul 8, 2007; 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.