Provider Demographics
NPI:1932279320
Name:LUQUIS-APONTE, WILMA (DMD)
Entity Type:Individual
Prefix:
First Name:WILMA
Middle Name:
Last Name:LUQUIS-APONTE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 CROWN POINT DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-4806
Mailing Address - Country:US
Mailing Address - Phone:915-204-7857
Mailing Address - Fax:
Practice Address - Street 1:222 RICK FRANCIS ST
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79905-2817
Practice Address - Country:US
Practice Address - Phone:915-215-6700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-09
Last Update Date:2023-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX199931223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX042853403Medicaid