NPIMap

Organization Active NPI

Jackson Creek Dental Center

Doing business as University Dental Center

  • General Practice Dentistry
  • Edinburg, TX
National Provider Identifier
1962700161
Registry record updated May 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
23289 Issued in TX
Legal business name
JACKSON CREEK DENTAL CENTER
Doing business as
University Dental Center
Practice address
212 Remington Ave
Edinburg, TX 78539-3930
Phone
(956) 380-6933
Fax
(956) 383-8986
NPI assigned
Mar 11, 2011
Last updated
May 5, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2021

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

Authorized official

Name
Cristina Guajardo
Title
Office Manager
Phone
(956) 316-1600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 23289 TX Primary

Addresses

Primary practice location

212 Remington Ave
Edinburg, TX 78539-3930

Mailing address

212 Remington Ave
Edinburg, TX 78539-3930
Phone (956) 380-6933

Other names 1

  • University Dental Center Doing business as

National Provider Directory

National Provider Directory

Locations

212 Remington Ave
Edinburg, TX 78539
Phone (956) 316-1600

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1299801600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620172800000",
    "number": "1962700161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 REMINGTON AVE",
            "city": "EDINBURG",
            "state": "TX",
            "postal_code": "785393930",
            "telephone_number": "956-380-6933",
            "fax_number": "956-383-8986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 REMINGTON AVE",
            "city": "EDINBURG",
            "state": "TX",
            "postal_code": "785393930",
            "telephone_number": "956-380-6933",
            "fax_number": "956-383-8986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON CREEK DENTAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-11",
        "last_updated": "2021-05-05",
        "certification_date": "2021-05-05",
        "status": "A",
        "authorized_official_last_name": "GUAJARDO",
        "authorized_official_first_name": "CRISTINA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "956-316-1600"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "23289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "University Dental Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 May 5, 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.