Individual provider Active NPI

Alan D Merta, DDS

  • General Practice Dentistry
  • Brownsville, TX
National Provider Identifier
1891830279
Registry record updated Dec 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
22778 Issued in TX
Practice address
1601 E Alton Gloor Blvd
Ste. 108
Brownsville, TX 78526-3902
Phone
(956) 621-3333
Fax
(956) 621-3336
NPI assigned
Feb 21, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2016

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 22778 TX Primary

Addresses

Primary practice location

1601 E Alton Gloor Blvd
Ste. 108
Brownsville, TX 78526-3902

Mailing address

1601 E Alton Gloor Blvd
Ste. 108
Brownsville, TX 78526-3902
Phone (956) 621-3333

Other identifiers 3

IdentifierTypeStateIssuer
180642404MedicaidTX
D22778OtherTXTEXAS CHIP
205292984OtherTXFEDERAL TAX ID

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20160414000352 TX Order and Referring Only - DentistPractitioner - Dentist 2163720707

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481760000000",
    "number": "1891830279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 E ALTON GLOOR BLVD",
            "address_2": "STE. 108",
            "city": "BROWNSVILLE",
            "state": "TX",
            "postal_code": "785263902",
            "telephone_number": "956-621-3333",
            "fax_number": "956-621-3336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 E ALTON GLOOR BLVD",
            "address_2": "STE. 108",
            "city": "BROWNSVILLE",
            "state": "TX",
            "postal_code": "785263902",
            "telephone_number": "956-621-3333",
            "fax_number": "956-621-3336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERTA",
        "first_name": "ALAN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-21",
        "last_updated": "2016-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "22778",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "180642404",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS CHIP",
            "identifier": "D22778",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL TAX ID",
            "identifier": "205292984",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brownsville, TX

Sources for this page

Verify at the official NPI Registry.