NPIMap

Organization Active NPI

Pebble Hills Dental Care

  • General Practice Dentistry
  • El Paso, TX
National Provider Identifier
1982057576
Registry record updated Jul 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
30538 Issued in TX
Legal business name
PEBBLE HILLS DENTAL CARE
Practice address
11680 Pebble Hills Blvd
101 And 102
El Paso, TX 79936-1090
Phone
(915) 201-2555
Fax
(915) 845-9746
NPI assigned
Jul 19, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2016

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

Authorized official

Name
Dr. Geetu Lagoo, DDS
Title
Owner/Provider
Phone
(510) 396-0109

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 30538 TX Primary

Addresses

Primary practice location

11680 Pebble Hills Blvd
101 And 102
El Paso, TX 79936-1090

Mailing address

11680 Pebble Hills Blvd
101 And 102
El Paso, TX 79936-1090
Phone (915) 201-2555

National Provider Directory

National Provider Directory

Locations

11680 Pebble Hills Blvd
Ste 101
El Paso, TX 79936
Phone (915) 201-2555

NPI Registry JSON

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

{
    "created_epoch": "1468886400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468886400000",
    "number": "1982057576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11680 PEBBLE HILLS BLVD",
            "address_2": "101 AND 102",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799361090",
            "telephone_number": "915-201-2555",
            "fax_number": "915-845-9746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11680 PEBBLE HILLS BLVD",
            "address_2": "101 AND 102",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799361090",
            "telephone_number": "915-201-2555",
            "fax_number": "915-845-9746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEBBLE HILLS DENTAL CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-19",
        "last_updated": "2016-07-19",
        "status": "A",
        "authorized_official_last_name": "LAGOO",
        "authorized_official_first_name": "GEETU",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "510-396-0109",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "30538",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 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.