EDINBURG DENTAL, PLLC (NPI# 1104364165) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104364165 |
| Entity Type | Organization |
| Organization Name | EDINBURG DENTAL, PLLC |
| Practice Address |
423 W Fm 495 San Juan TX 78589-3717 |
| Mailing Address |
Po Box 102 San Juan TX 78589-0102 |
| Practice Telephone | 9565376764 |
| Mailing Telephone | 9565376764 |
| Enumeration Date | 2017-02-09 |
| Last Update Date | 2017-02-09 |
| Authorized Official Name | DR. SERGIO IVAN GUZMAN (PEDIATRIC DENTIST/OWNER) |
| Authorized Official Telephone | 9565376764 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
22644 | TX | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 802626200 | 05 |
| Street Address |
423 W FM 495 |
| City | SAN JUAN |
| State | TX |
| Zip Code | 78589-3717 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417598814 | Nueva Vida Primary Home Care LLC | In Home Supportive Care | 213 W. Business 83, San Juan, TX 78589 | 2019-10-07 |
| 1396207858 | Heart To Heart Talks, LLC | Counselor | 409 W. Fm 495, San Juan, TX 78589 | 2019-04-03 |
| 1386131209 | L4 Family Investments, LLC. | Technician | 1709 S Stewart Rd, San Juan, TX 78589 | 2018-04-16 |
| 1558741553 | Paraiso Dental Pllc | Clinic/Center | 1618 N Veterans Blvd Suite A, San Juan, TX 78589 | 2015-06-04 |
| 1811325970 | Liquid Dental, Pllc | Dentist | 105 South Cesar Chavez Road, Suite #2, San Juan, TX 78589 | 2013-10-28 |
| 1598021966 | Kids Dental & Orthodontics | Dentist | 1618 N. I Road Suite A, San Juan, TX 78589 | 2012-04-10 |
| 1003180704 | Cvs Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 100 E Fm 495, San Juan, TX 78589 | 2012-02-28 |
| 1598074932 | Chukwunonso Jideofor Azikiwe | Physical Therapy Assistant | 407 W. State Hwy 495, San Juan, TX 78589 | 2010-10-04 |
| 1093044539 | Melissa Rivera Dds Pa | Dentist | 4500 N Raul Longoria Street, San Juan, TX 78589 | 2009-12-11 |
| 1598995607 | Marivel Lydia Cavazos | Nurse Practitioner | 1211 N. Raul Longoria Ra. Ste C, San Juan, TX 78589 | 2009-07-23 |
| Find all providers in zip 78589 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083198576 | San Juan Dental Center LLC | Dentist | 456 Calle Cesar Gonzalez, San Juan, PR 00918-2628 | 2018-09-20 |
| 1508122094 | Little Manhattan Pediatric Dentistry,pllc | Dentist | 423 W. Highway 495, San Juan, TX 78589-9998 | 2012-04-09 |
| 1295852598 | Escuela De Odontologia | Dentist | Ave Barbosa 608, Clinica Dental Comunitaria Cantera Suite 4, San Juan, PR 00919-1274 | 2007-03-23 |
| 1467594721 | Alexis R. Pagan | Dentist | 253 Calle San Jorge Ste I-a, San Jorge II Medical Building, San Juan, PR 00912-3307 | 2007-02-13 |
| 1003953134 | Rosa M Rodriguez | Dentist | 377 Ave Domenech, San Juan, PR 00918-3721 | 2007-01-30 |
| 1225181266 | University of Puerto Rico Msc | Dentist | Pediatric Dentistry Clinics, Centro Medico, San Juan, PR 00935-0001 | 2007-01-22 |
| 1780736520 | Anabel Noriega | Dentist | 525 F D Roosevelt Ave, Suite 704 Plaza Las Americas Tower, San Juan, PR 00918 | 2007-01-18 |
| 1457415275 | Adolfo Correa-luna | Dentist | 1165 Ave Jesus T Pinero, San Juan, PR 00920-5604 | 2006-12-19 |
| 1083625776 | Sandra Patricia Cerda | Dentist | 281 Ave Jesus T Pinero, Plaza El Amal, Suite 211, San Juan, PR 00927-3901 | 2006-08-10 |
| 1104876515 | Dagnes Y Calderon | Dentist | G15 Calle 8, El Mirador, San Juan, PR 00926-7576 | 2006-05-10 |
| Find all providers in SAN JUAN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.