Tx Southern Dental PPO PC
NPI 1902676380ActiveOrganization· Dentist· Bedford, TX
Dentist in Bedford, Texas, registered in NPPES in January 2024, part of Tx Southern Dental PPO PC. The authorized official on file is Erika Melissa Menjivar, Sr. Credentialing Specialist.
Overview
| NPI | 1902676380 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Tx Southern Dental PPO PC |
| NPI issued | Jan 5, 2024 |
| Last updated in NPPES | Aug 13, 2025 |
| Certified by provider | Aug 13, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist Primary | 122300000X | — | — |
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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