Individual provider Active NPI

Josefa Del Carmen Jaravalero, EFDA

  • Dental Assistant
  • Fort Hood, TX
National Provider Identifier
1912356346
Registry record updated Jun 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental AssistantTaxonomy code 126800000X
License
1852 Issued in TX
Practice address
4431 68TH St
Fort Hood, TX 76544-5042
Phone
(254) 287-1225
Fax
(254) 287-9685
NPI assigned
Jun 7, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Assistant 126800000X 1852 TX Primary

Addresses

Primary practice location

4431 68TH St
Fort Hood, TX 76544-5042

Mailing address

4431 68TH St
Fort Hood, TX 76544-5042
Phone (254) 287-1225

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
1852TXMDFoot & Ankle Surgery Podiatrist

NPI Registry JSON

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

{
    "created_epoch": "1465257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465257600000",
    "number": "1912356346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4431 68TH ST",
            "city": "FORT HOOD",
            "state": "TX",
            "postal_code": "765445042",
            "telephone_number": "254-287-1225",
            "fax_number": "254-287-9685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4431 68TH ST",
            "city": "FORT HOOD",
            "state": "TX",
            "postal_code": "765445042",
            "telephone_number": "254-287-1225",
            "fax_number": "254-287-9685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JARAVALERO",
        "first_name": "JOSEFA",
        "middle_name": "DEL CARMEN",
        "credential": "EFDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-07",
        "last_updated": "2016-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "126800000X",
            "taxonomy_group": "",
            "desc": "Dental Assistant",
            "state": "TX",
            "license": "1852",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Hood, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2016; 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.