Provider Demographics
NPI:1780225284
Name:FOX, AISLEN YVETTE (DDS)
Entity Type:Individual
Prefix:DR
First Name:AISLEN
Middle Name:YVETTE
Last Name:FOX
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:AISLEN
Other - Middle Name:YVETTE
Other - Last Name:MEDINA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1300 S 1ST 1/2 ST # TX
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-1107
Mailing Address - Country:US
Mailing Address - Phone:956-802-4031
Mailing Address - Fax:
Practice Address - Street 1:4733 S JACKSON RD
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-8381
Practice Address - Country:US
Practice Address - Phone:956-329-2808
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-05
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXETN7091223G0001X
TX37143122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice