ELISE ODOM (NPI# 1194256115) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194256115 |
| Entity Type | Individual |
| Full Name | ELISE ODOM |
| Credential | R.D.A |
| Practice Address |
2701 S 77 Sunshinestrip Harlingen TX 78550-8318 |
| Mailing Address |
105 Dickey St Fort Polk LA 71459-3546 |
| Practice Telephone | 9564309355 |
| Practice Fax Number | 9564309373 |
| Mailing Telephone | 9564309355 |
| Mailing Fax Number | 9564309373 |
| Enumeration Date | 2017-03-22 |
| Last Update Date | 2017-03-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 126800000X | Dental Assistant | 35682 | TX | Dental Providers |
| Street Address |
2701 S 77 SUNSHINESTRIP |
| City | HARLINGEN |
| State | TX |
| Zip Code | 78550-8318 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114215159 | David M Jacobson | Social Worker | 2701 S 77 Sunshinestrip, Harlingen, TX 78550-8318 | 2011-07-12 |
| 1811468556 | Ronda Wickel | Social Worker | 2701 S 77 Sunshinestrip, Harlingen, TX 78550-8318 | 2018-12-06 |
| 1962750315 | Veayla Williams | Psychologist | 2701 S 77 Sunshinestrip, Harlingen, TX 78550-8318 | 2012-08-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598378077 | Bruce Dylan Bauer | Pharmacist | 1921 South Sunshine Strip, Harlingen, TX 78550 | 2020-08-25 |
| 1952920647 | Av Rehab LLC | Skilled Nursing Facility | 2902 S 77 Sunshine Strip, Harlingen, TX 78550 | 2020-04-13 |
| 1982260105 | Daniella Concha | Student in an Organized Health Care Education/Training Program | 3102 Haine Drive, Apt 411, Harlingen, TX 78550 | 2019-05-13 |
| 1669036539 | Ayman Khaddam | Student in an Organized Health Care Education/Training Program | 2121 Pease Street, Mob Suite 200, Vbmc - Utrgv Im, Harlingen, TX 78550 | 2019-04-26 |
| 1104382738 | Abrazos De Jesus Healthcare, LLC | Home Health | 804 N Commerce, Harlingen, TX 78550 | 2019-02-19 |
| 1912462136 | Deep Sea Dental Pllc | Clinic/Center | 603 South Expressway 83, Suite H2, Harlingen, TX 78550 | 2019-02-01 |
| 1710442082 | Mary Angela Alexander | Dietitian, Registered | 1740 Christian Cir, Harlingen, TX 78550 | 2019-01-31 |
| 1376025080 | El Valle Quality Home Care | Technician | 1212 E. Harrison Ave, Suite 136, Harlingen, TX 78550 | 2018-08-30 |
| 1144717547 | Velma Hughes | Nurse Practitioner | 2424 Riverside Drive, Harlingen, TX 78550 | 2018-04-20 |
| 1730686494 | Angelica Maria Ortiz | Student in an Organized Health Care Education/Training Program | Utrgv Psychiatry Residency Program, 2102 Treasure Hills Blvd, Harlingen, TX 78550 | 2018-04-10 |
| Find all providers in zip 78550 | ||||
| Taxonomy Code | 126800000X |
| Grouping | Dental Providers |
| Classification | Dental Assistant |
| An individual who may or may not have completed an accredited dental assisting education program and who aids the dentist in providing patient care services and performs other nonclinical duties in the dental office or other patient care facility. The scope of the patient care functions that may be legally delegated to the dental assistant varies based on the needs of the dentist the educational preparation of the dental assistant and state dental practice acts and regulations. Patient care services are provided under the supervision of a dentist. To avoid misleading the public, no occupational title other than dental assistant should be used to describe this dental auxiliary. |
| Notes: Source: Comprehensive Policy Statement on Dental Auxiliaries, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275090961 | Shelby Morgan Tullos | Dental Assistant | 821 Fm 1970 N, Timpson, TX 75975 | 2019-02-28 |
| 1215494901 | Shelby Lauren Bryan | Dental Assistant | 529 Marshall Ivy Rd, Huntington, TX 75949 | 2019-02-28 |
| 1780163253 | Dimitri House-gaston | Dental Assistant | 5005 N.piedras, El Paso, TX 79920-5001 | 2018-08-07 |
| 1083111959 | Jessica Michelle Holmes | Dental Assistant | 4980 Sean Haggerty Dr Apt 373, El Paso, TX 79934-3342 | 2018-04-09 |
| 1942706924 | Joaimy Estefani Nash | Dental Assistant | 2404 Mikulec Dr, Killeen, TX 76542-4661 | 2018-03-30 |
| 1497250831 | Jessica Nicole King | Dental Assistant | 1609 Excel Dr, Killeen, TX 76542-6315 | 2018-03-28 |
| 1376053090 | Sarah Thrutchley | Dental Assistant | 11201 Lynbrook Dr Apt 2802, Houston, TX 77042-1358 | 2017-10-08 |
| 1205385523 | Jose Escobar | Dental Assistant | 31315 Fm 2920 Rd Ste 16a, Waller, TX 77484-8022 | 2016-09-28 |
| 1275089807 | Jaqueline Mendoza | Dental Assistant | 11334 Ssg Sims, Ft. Bliss, TX 79908 | 2016-09-01 |
| 1750838207 | Iliana Duran | Dental Assistant | 11334 Ssg Sims Rd, Ft. Bliss, TX 79908 | 2016-09-01 |
| Find all providers with the same taxonomy | ||||
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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.