NPIMap

Organization Active NPI

Lubbock Dental and Orthodontics PLLC

Doing business as Rodeo Dental and Orthodontics

  • Dentist
  • Lubbock, TX
National Provider Identifier
1861383622
Registry record updated Jul 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
LUBBOCK DENTAL AND ORTHODONTICS PLLC
Doing business as
Rodeo Dental and Orthodontics
Practice address
4501 114TH St.
Ste 200
Lubbock, TX 79424
Phone
(817) 529-8151
NPI assigned
Jul 10, 2025
Last updated
Jul 10, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2025

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

Authorized official

Name
Raffy Kouyoumdjian
Title
Owner
Phone
(817) 529-8151

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X NU Primary

Addresses

Primary practice location

4501 114TH St.
Ste 200
Lubbock, TX 79424

Mailing address

8505 Freeport Pkwy Ste 600
Irving, TX 75063-2549

Other names 1

  • Rodeo Dental and Orthodontics Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1752105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752105600000",
    "number": "1861383622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8505 FREEPORT PKWY STE 600",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750632549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4501 114TH ST.",
            "address_2": "STE 200",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "79424",
            "telephone_number": "817-529-8151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUBBOCK DENTAL AND ORTHODONTICS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-10",
        "last_updated": "2025-07-10",
        "certification_date": "2025-06-25",
        "status": "A",
        "authorized_official_last_name": "KOUYOUMDJIAN",
        "authorized_official_first_name": "RAFFY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-529-8151"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rodeo Dental and Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lubbock, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2025; 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.