Wendy Lynn Lara, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DD2498 Issued in NM

Practice address

3932 Fort Blvd
El Paso, TX 79930-6208

Phone

(915) 566-9415

NPI assigned

Jun 22, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NM

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

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://epicproxy.et1256.epichosted.com/FHIRProxy/api/FHIR/R4/

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.

• Ben Archer Health Center

  • Federally Qualified Health Center (FQHC)
  • Truth Or Consequences, NM
  • NPI 1871528505
  Medicare reassignment NPD
• Ben Archer Health Center

  • Federally Qualified Health Center (FQHC)
  • Hatch, NM
  • NPI 1154352532
  NPD
• Ben Archer Health Center

  • Federally Qualified Health Center (FQHC)
  • Deming, NM
  • NPI 1194443135
  NPD
• DDC El Paso PLLC

  • Dental Clinic/Center
  • El Paso, TX
  • NPI 1710672274
  NPD (past)
• University Family Dental PC

  • Dentist
  • Las Cruces, NM
  • NPI 1396174116
  NPD (past)

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

{
    "created_epoch": "1119398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1821094228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 HWY 187",
            "address_2": "PO BOX 370",
            "city": "HATCH",
            "state": "NM",
            "postal_code": "879370370",
            "telephone_number": "575-267-3280",
            "fax_number": "575-267-1747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3932 FORT BLVD",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799306208",
            "telephone_number": "915-566-9415"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "705 E University Ave Ste B",
            "address_purpose": "LOCATION",
            "city": "Las Cruces",
            "state": "NM",
            "postal_code": "880015637",
            "country_code": "US",
            "telephone_number": "575-521-0127",
            "fax_number": "575-647-9533",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3331 Del Rey Blvd",
            "address_purpose": "LOCATION",
            "city": "Las Cruces",
            "state": "NM",
            "postal_code": "880127713",
            "country_code": "US",
            "telephone_number": "575-373-1033",
            "fax_number": "575-373-1265",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LARA",
        "first_name": "WENDY",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-22",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "30661",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NM",
            "license": "DD2498",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "46327771",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marisol Lara, LCSW
• Michael David Lara, M.D.
• Olivia Lara
• Patricia Lara, SLP
• Samantha Lara
• Xochitl Lara, RN
• Yvonne Lara
• Gloria Marie Lares
• Luis Lares
• Matthew Jacob Lares, PT

• 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 Mar 17, 2018; 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.