MEDICARE: DR. ADAM JAMES ORTEGA DMD, MS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	25893	TX

General Provider Information

NPI Number	:	1780669317
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ADAM JAMES ORTEGA DMD, MS

Provider Business Mailing Address
First Line	:	9506 SHOREVIEW RD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75238-4235
Country	:	US
Telephone Number	:	214-613-2122
Fax Number	:	214-613-2127

Provider Business Practice Location Address
First Line	:	9440 GARLAND RD
Second Line	:	STE. 198
City	:	DALLAS
State	:	TX
Zip	:	75218-5003
Country	:	US
Telephone Number	:	214-613-2122
Fax Number	:	214-613-2127

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/06/2005
Last Update Date	:	04/01/2011

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