Provider Demographics
NPI:1689177925
Name:MC DENTAL CARE OF EDINBURG, PLLC
Entity Type:Organization
Organization Name:MC DENTAL CARE OF EDINBURG, PLLC
Other - Org Name:JIMENEZ FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARTIZA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAVEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:956-583-2588
Mailing Address - Street 1:2413 E INTERSTATE HIGHWAY 2 STE 50
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78572-1019
Mailing Address - Country:US
Mailing Address - Phone:956-583-5430
Mailing Address - Fax:
Practice Address - Street 1:8814 E HWY 107 STE B
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78542-3760
Practice Address - Country:US
Practice Address - Phone:956-800-2219
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-13
Last Update Date:2021-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX289081223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty