Provider Demographics
NPI:1184010712
Name:EL PASO SUNNY HILLS FAMILY DENTAL, PLLC
Entity Type:Organization
Organization Name:EL PASO SUNNY HILLS FAMILY DENTAL, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:CHIANG-MCCASLAND
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:806-332-5090
Mailing Address - Street 1:6555 N MESA ST
Mailing Address - Street 2:EP SUNNY HILLS FAMILY DENTAL
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912
Mailing Address - Country:US
Mailing Address - Phone:915-584-5457
Mailing Address - Fax:
Practice Address - Street 1:1801 N 14TH ST
Practice Address - Street 2:EP SUNNY HILLS FAMILY DENTAL
Practice Address - City:LAMESA
Practice Address - State:TX
Practice Address - Zip Code:79331-2809
Practice Address - Country:US
Practice Address - Phone:806-332-5090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-10
Last Update Date:2015-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19992122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty