Provider Demographics
NPI:1295835676
Name:MUNOZ, YLEANA I (DDS)
Entity Type:Individual
Prefix:DR
First Name:YLEANA
Middle Name:I
Last Name:MUNOZ
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 E. SCHUSTER ST 5
Mailing Address - Street 2:EL PASO SMILES CENTER, PLLC
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902
Mailing Address - Country:US
Mailing Address - Phone:915-533-3435
Mailing Address - Fax:915-533-3784
Practice Address - Street 1:615 E. SCHUSTER ST 5
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902
Practice Address - Country:US
Practice Address - Phone:915-533-3435
Practice Address - Fax:915-533-3784
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2015-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX20665122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX171719101Medicaid