DR. DANIEL WILLIAM SUDIMACK (NPI# 1770895815) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770895815 |
| Entity Type | Individual |
| Full Name | DR. DANIEL WILLIAM SUDIMACK |
| Credential | D.D.S. |
| Practice Address |
4875 Maxwell Ave El Paso TX 79904-1559 |
| Practice Telephone | 9153139908 |
| Mailing Telephone | 9153139908 |
| Enumeration Date | 2010-07-06 |
| Last Update Date | 2016-04-06 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 25701 | TX | Dental Providers |
| Street Address |
4875 MAXWELL AVE |
| City | EL PASO |
| State | TX |
| Zip Code | 79904-1559 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609973221 | Audree Jean Reynolds | Nurse Practitioner | 4875 Maxwell Ave, El Paso, TX 79904-1450 | 2006-09-17 |
| 1104423656 | Lissette Angelica Amparan | Social Worker | 4875 Maxwell Ave, El Paso, TX 79904-1559 | 2020-10-07 |
| 1881034395 | Sandra Villavicencio | Family Medicine | 4875 Maxwell Ave, El Paso, TX 79904-1559 | 2013-06-28 |
| 1992016620 | Crystal Estrada | Dentist | 4875 Maxwell Ave, El Paso, TX 79904-1559 | 2010-06-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700385762 | Matthew Jacob Lares | Physical Therapist | 4242 Hondo Pass Drive Suite 110, El Paso, TX 79904 | 2018-02-06 |
| 1598263170 | Jennifer Suzanne Banks | Registered Nurse | 7760 Alabama Street, El Paso, TX 79904 | 2018-01-29 |
| 1508306796 | Jacqueline Gazelle Romero | Specialist/Technologist | 4601 Hondo Pass Dr Ste A, El Paso, TX 79904 | 2017-03-07 |
| 1306215967 | Dsi El Paso North, LLC | Clinic/Center | 3359 Fred Wilson Avenue, El Paso, TX 79904 | 2015-09-24 |
| 1225380587 | El Paso Eyecare Pllc | Optometrist | 9009 Gateway Blvd. South, El Paso, TX 79904 | 2012-10-11 |
| 1154617819 | Edward J Valdez | Durable Medical Equipment & Medical Supplies | 8888 Dyer St Ste 102, El Paso, TX 79904 | 2011-06-21 |
| 1548469521 | Wainwright Family Resource Center | Pediatrics | 4417 Tetons, El Paso, TX 79904 | 2007-07-11 |
| 1730256355 | Luis Raul Munoz | Pediatrics | 2900 N. Kansas St, El Paso, TX 79904 | 2006-11-29 |
| 1912012139 | Travis M Hausler | Dentist | 4721 Sierra Madre, El Paso, TX 79904 | 2006-08-20 |
| 1962422097 | Alexandra Jordan | Nurse Practitioner | 4417 Tetons Drive, El Paso, TX 79904 | 2006-07-20 |
| Find all providers in zip 79904 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548882863 | Healing Dentistry Ep Pllc | Dentist | 7955 N Mesa St Ste A, El Paso, TX 79932-1625 | 2020-05-08 |
| 1578030276 | Connor Family Dentistry East Pllc | Dentist | 1920 N. Zaragoza Rd., Suite 107, El Paso, TX 79938 | 2018-10-31 |
| 1114407970 | Ep Dental Sleep Medicine, Pllc | Dentist | 6901 Helen of Troy Ste D2, El Paso, TX 79911-3130 | 2018-08-20 |
| 1689175697 | Michael Grant | Dentist | 5939 Gateway Blvd W, El Paso, TX 79925-3323 | 2018-02-24 |
| 1891211322 | Mendoza Family Dentistry Pllc | Dentist | 6351 S Desert Blvd Ste 210, El Paso, TX 79932-1233 | 2017-08-16 |
| 1275061822 | Weronika Paula Douglas | Dentist | 3650 Joe Battle Blvd, El Paso, TX 79938-2628 | 2017-05-26 |
| 1679006514 | Jose Carlos Noriega | Dentist | 112 De Leon Dr, El Paso, TX 79912-4510 | 2017-04-07 |
| 1063969152 | Rahul Patel | Dentist | 1188 N Yarbrough Dr Ste A, El Paso, TX 79925-7926 | 2016-09-06 |
| 1669927059 | Rodolfo Cereceres | Dentist | 7040 N Mesa St Ste A, El Paso, TX 79912-3667 | 2016-08-16 |
| 1407214646 | Wiscott International Health Services Inc. | Dentist | 1205 Diamond Cove Pl, El Paso, TX 79912-7487 | 2016-02-02 |
| 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.