Crystal Estrada, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

25629 Issued in TX

Practice address

4875 Maxwell Ave
El Paso, TX 79904-1559

Phone

(915) 533-7057

Fax

(915) 757-1640

NPI assigned

Jun 28, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

State licenses

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

{
    "created_epoch": "1277683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323820800000",
    "number": "1992016620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4875 MAXWELL AVE",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799041559",
            "telephone_number": "915-533-7057",
            "fax_number": "915-757-1640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4875 MAXWELL AVE",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799041559",
            "telephone_number": "915-533-7057",
            "fax_number": "915-757-1640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESTRADA",
        "first_name": "CRYSTAL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-28",
        "last_updated": "2011-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "25629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sylvia Helena Estrada Porras, SA-C
• Aimee NG Estrada
• Amanda Estrada, FNP-BC
• Blanca Jacinta Estrada
• Brianna Luz Estrada
• Cynthia Haide Estrada, CPNP
• Diane Estrada, RN
• Ivy Alysa Estrada
• Jacqueline Estrada, NP
• Jesse Estrada, MPAS, PA-C

• General Practice Dentistry in El Paso, TX
• Providers in El Paso, 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 Dec 14, 2011; 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.