Provider Demographics
NPI:1891898920
Name:ARTHUR T BURCIAGA DDS PC
Entity type:Organization
Organization Name:ARTHUR T BURCIAGA DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:BURCIAGA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:915-581-1511
Mailing Address - Street 1:7181 WESTWIND DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-1782
Mailing Address - Country:US
Mailing Address - Phone:915-581-1511
Mailing Address - Fax:915-581-6049
Practice Address - Street 1:7181 WESTWIND DR
Practice Address - Street 2:SUITE A
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-1782
Practice Address - Country:US
Practice Address - Phone:915-581-1511
Practice Address - Fax:915-581-6049
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16040122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXB16040OtherDELTA CHIP PROVIDER ID#
NM12357Medicaid
TXD16040OtherBC BS PROVIDER #
TX48983OtherUNITED HEALTHCARE PROV #
TX801043OtherUNITED CONCORDIA INS. CO