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RODEO LAREDO DENTAL & ORTHODONTICS PLLC NPI 1548611452


NPI Information

NPI: 1548611452
Provider Name: RODEO LAREDO DENTAL & ORTHODONTICS, PLLC

Doing Business As: RODEO DENTAL AND ORTHODONTICS

Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

Address:
910 GUADALUPE ST STE A
LAREDO, TX
ZIP 78040
Phone: (817) 529-8151
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RODEO LAREDO DENTAL & ORTHODONTICS, PLLC is a general practice dentist in Laredo, TX. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. RODEO LAREDO DENTAL & ORTHODONTICS, PLLC NPI is 1548611452. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Rodeo Dental And Orthodontics.

The provider's business location address is:

910 GUADALUPE ST STE A
LAREDO, TX
ZIP 78040-280
Phone: (817) 529-8151

The provider's authorized official is Raffy Kouyoumdjian .
The authorized official title is Owner and has the following contact phone number (972) 814-2708.

The enumeration date for this NPI number is 6/22/2016 and was last updated on 2/20/2017.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223G0001XDentistGeneral PracticeYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1182419510MEDICAIDTEXAS
2182419511MEDICAIDTEXAS
3182419515MEDICAIDTEXAS
4182419514MEDICAIDTEXAS
5182419513MEDICAIDTEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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