David Elizondo, DDS.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

21368 Issued in TX

Practice address

2707 W Trenton Rd
Edinburg, TX 78539-3433

Phone

(956) 630-4899

Fax

(956) 630-6599

NPI assigned

Jul 11, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Nuestra Clinica del Valle, Inc.

  • Federally Qualified Health Center (FQHC)
  • San Juan, TX
  • NPI 1053728360
  NPD (past)

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

{
    "created_epoch": "1121040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592956800000",
    "number": "1962400259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2707 W TRENTON RD",
            "city": "EDINBURG",
            "state": "TX",
            "postal_code": "785393433",
            "telephone_number": "956-630-4899",
            "fax_number": "956-630-6599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2707 W TRENTON RD",
            "city": "EDINBURG",
            "state": "TX",
            "postal_code": "785393433",
            "telephone_number": "956-630-4899",
            "fax_number": "956-630-6599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELIZONDO",
        "first_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "DDS.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-11",
        "last_updated": "2020-06-24",
        "certification_date": "2020-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "21368",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "158093803",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elena Bedilo DMD, Inc
• Elite Obstetrics & Gynecology of South Texas PLLC
• Elite Rehab Services, L.L.C.
• Sandra Elizama, COTA
• Anniella Elizondo
• Eutiquio M Elizondo Jr., DDS
• Oneida Elizondo, FNP
• Paola Elizondo
• Roberto Elizondo Jr., LPC
• Samantha Joy Elizondo, M.S., CCC-SLP

• General Practice Dentistry in Edinburg, TX
• Providers in Edinburg, 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 Jun 24, 2020; 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.