STEVENSON DENTAL CLINIC FOR CHILDREN (NPI# 1417027251) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417027251 |
| Entity Type | Organization |
| Organization Name | STEVENSON DENTAL CLINIC FOR CHILDREN |
| Other Organization Name | PROFESSIONAL ASSOCIATE |
| Practice Address |
11165 La Quinta Place El Paso TX 79936 |
| Practice Telephone | 9155911999 |
| Practice Fax Number | 9155913201 |
| Mailing Telephone | 9155911999 |
| Mailing Fax Number | 9155913201 |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2009-10-01 |
| Authorized Official Name | DR. EUGENE DAVIS STEVENSON JR. (OWNER) |
| Authorized Official Telephone | 9155911999 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
13513 | TX | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| DELTA CHIP | G601421 | 01 | |
| BCBS | D13513 | 01 | |
| TX | 111009002 | 05 | |
| UNITED CONCORDIA | 828328 | 01 |
| Other Name | Type Code |
|---|---|
| Professional Associate | Other Name - Individual/Organization |
| Street Address |
11165 LA QUINTA PLACE |
| City | EL PASO |
| State | TX |
| Zip Code | 79936 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285233171 | Center At Zaragoza, LLC | Skilled Nursing Facility | 12660 Pebble Hills Blvd., El Paso, TX 79936 | 2020-10-21 |
| 1346889953 | Georges Chiropractic and Wellness Center, Pa | Chiropractor | 1400 N Zaragosa Suite D, El Paso, TX 79936 | 2019-12-30 |
| 1316597768 | Larry Felix | Specialist/Technologist | 11720 Teachers Dr., El Paso, TX 79936 | 2019-09-18 |
| 1508323486 | Aaron John Palos | Pharmacist | 11320 Montwood, Pharmacy, El Paso, TX 79936 | 2019-02-27 |
| 1366919508 | Katrina Belvin | Social Worker | 1390 Georger Dieter Dr., #140, El Paso, TX 79936 | 2018-10-25 |
| 1063993244 | Assisted Living | Meals | 11065 Tom Weiskopf Dr, El Paso, TX 79936 | 2018-08-24 |
| 1588142962 | Miriam Salazar | Occupational Therapy Assistant | 1351 James Watt Dr., El Paso, TX 79936 | 2018-07-30 |
| 1902315179 | David Galindo | Occupational Therapist | 1415 Zaragoza, El Paso, TX 79936 | 2017-09-20 |
| 1861915589 | Lizette Salcido | Behavior Technician | 3221 Running Deer Dr., El Paso, TX 79936 | 2017-07-25 |
| 1659801264 | Edith Nneoma Vincent | Registered Nurse | 11829 Gwen Evans Ln, El Paso, TX 79936 | 2017-06-15 |
| Find all providers in zip 79936 | ||||
| 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 |
|---|---|---|---|---|
| 1659710259 | Edith Osorio | Dentist | 1800 Mcrae Boulevard, El Paso, TEXAS 79925 | 2013-06-18 |
| 1619106960 | Lizbeth Holguin | Dentist | 1800 Mc Rae Blvd, El Paso, TX 79925-6706 | 2009-07-08 |
| 1396990867 | Maureen Dinah Poux | Dentist | 11165 La Quinta Pl, El Paso, TX 79936-5221 | 2008-11-24 |
| 1548200868 | Rodney David Mollere | Dentist | 7005 Westwind Drive, El Paso, TX 79912-1729 | 2006-06-07 |
| 1831151505 | Yadah Sringam | Dentist | 11965 Pellicano Dr, El Paso, TX 79936-6829 | 2006-04-06 |
| 1447210083 | Courtney Mei-young Brooks | Dentist | 1800 Mcrae Blvd, El Paso, TX 79925-6706 | 2006-03-27 |
| 1700395498 | Edgar L Perales | Dentist | 1800 Mcrae Blvd, El Paso, TX 79925-6706 | 2017-09-25 |
| 1396139390 | Stevensons Dental Ark Pllc | Dentist | 11165 La Quinta Pl, El Paso, TX 79936-5221 | 2015-03-27 |
| 1356767701 | Cheng Yen Dmd | Dentist | 1475 George Dieter Dr Ste L1, El Paso, TX 79936-7634 | 2014-03-10 |
| 1972854438 | Joy Yvonne Cleveland | Dentist | 11965 Pellicano Dr, El Paso, TX 79936-6829 | 2012-09-25 |
| Find all providers in EL PASO | ||||
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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.