1780495267 NPI number — DR. BERHA ANGUIANO ANGUIANO DDS

Table of content: DR. BERHA ANGUIANO ANGUIANO DDS (NPI 1780495267)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1780495267 NPI number — DR. BERHA ANGUIANO ANGUIANO DDS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ANGUIANO ANGUIANO
Provider First Name:
BERHA
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DDS
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1780495267
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/14/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6101 GATEWAY WEST, SPC 520, PMB 85
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EL PASO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
79925
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2916 COYOACAN
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
JUAREZ
Provider Business Practice Location Address State Name:
MEXICO
Provider Business Practice Location Address Postal Code:
32300
Provider Business Practice Location Address Country Code:
MX
Provider Business Practice Location Address Telephone Number:
915-631-5260
Provider Business Practice Location Address Fax Number:
915-613-5260
Provider Enumeration Date:
01/15/2025

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  7545864 , registered in the state of ZZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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