Individual provider Active NPI

Anthony Conner Villarreal, DDS

  • General Practice Dentistry
  • Edinburg, TX
National Provider Identifier
1891179362
Registry record updated Feb 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
31215 Issued in TX
Practice address
1123 S 10TH Ave
Edinburg, TX 78539-5547
Phone
(956) 968-8713
Fax
(956) 973-9649
NPI assigned
Jul 15, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 31215 TX Primary

Addresses

Primary practice location

1123 S 10TH Ave
Edinburg, TX 78539-5547

Mailing address

1123 S 10TH Ave
Edinburg, TX 78539-5547
Phone (956) 968-8713

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
31215TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Dental Associates of Weslaco General Practice CurrentSince Aug 18, 2024 Accepting new patients
Ac Villarreal Family Dental General Practice PastSince Mar 4, 2021 Accepting new patients

Locations

1123 S 10th Ave
Edinburg, TX 78539
Phone (956) 318-3384

Organizations & group practices 2

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": "1436918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614038400000",
    "number": "1891179362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1123 S 10TH AVE",
            "city": "EDINBURG",
            "state": "TX",
            "postal_code": "785395547",
            "telephone_number": "956-968-8713",
            "fax_number": "956-973-9649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1123 S 10TH AVE",
            "city": "EDINBURG",
            "state": "TX",
            "postal_code": "785395547",
            "telephone_number": "956-968-8713",
            "fax_number": "956-973-9649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLARREAL",
        "first_name": "ANTHONY",
        "middle_name": "CONNER",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-15",
        "last_updated": "2021-02-23",
        "certification_date": "2021-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "31215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edinburg, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2021; 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.