STAR MOUNTAIN FAMILY DENTAL PLLC NPI 1164074829

NPI Information

NPI: 1164074829
Provider Name: STAR MOUNTAIN FAMILY DENTAL PLLC
Classification: Clinic/Center - 261QD0000X
Entity Type: Organization

Specialization: Dental

Address:
11601 PELLICANO DR
EL PASO, TX
ZIP 79936
Phone: (915) 594-4048
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STAR MOUNTAIN FAMILY DENTAL PLLC is a dental clinic center in El Paso, TX. STAR MOUNTAIN FAMILY DENTAL PLLC NPI is 1164074829. The provider is registered as an organization entity type.

The provider's business location address is:

11601 PELLICANO DR
EL PASO, TX
ZIP 79936-279
Phone: (915) 594-4048

The provider's authorized official is Jacquelyn Luera .
The authorized official title is Owner and has the following contact phone number (915) 594-4048.

The enumeration date for this NPI number is 7/12/2019 and was last updated on 7/12/2019.

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
1	261QD0000X	Clinic/Center	Dental			Yes

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: 4/28/2024

NPI Synchronization or Removal

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