Provider Demographics
NPI:1215046412
Name:ANDERTON, XOCHITL DUARTE (DDS)
Entity type:Individual
Prefix:DR
First Name:XOCHITL
Middle Name:DUARTE
Last Name:ANDERTON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:XOCHITL
Other - Middle Name:
Other - Last Name:RAMOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:9105 LOLA AVE
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79424
Mailing Address - Country:US
Mailing Address - Phone:806-495-3600
Mailing Address - Fax:806-303-5003
Practice Address - Street 1:1002 N. AVENUE S
Practice Address - Street 2:
Practice Address - City:POST
Practice Address - State:TX
Practice Address - Zip Code:79356
Practice Address - Country:US
Practice Address - Phone:806-495-3600
Practice Address - Fax:806-303-5003
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2024-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX21263122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist