5429 East Grand Ave Dental
NPI 1164121422ActiveOrganization· Dentist, General Practice· Dallas, TX
Dentist, General Practice in Dallas, Texas, registered in NPPES in February 2023. The authorized official on file is Maria Estrada, Billing/Credentialing Manager.
Overview
| NPI | 1164121422 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Feb 27, 2023 |
| Last updated in NPPES | Feb 27, 2023 |
| Certified by provider | Feb 25, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist, General Practice Primary | 1223G0001X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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