Provider Demographics
NPI:1992180376
Name:PARRA, MASSIEL (DMD)
Entity type:Individual
Prefix:DR
First Name:MASSIEL
Middle Name:
Last Name:PARRA
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 1:8901 VERTEX BLVD UNIT 130
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78747-2793
Mailing Address - Country:US
Mailing Address - Phone:512-677-7443
Mailing Address - Fax:512-333-2862
Practice Address - Street 1:8901 VERTEX BLVD UNIT 130
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78747-2793
Practice Address - Country:US
Practice Address - Phone:512-677-7443
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-27
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI02607900122300000X
NY0588601223P0221X
TX403481223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0491977Medicaid