NPI age
12 years
Enumerated 2014-05-20
● Active Type 2 · Organization
Port Lavaca Dentistry Pllc
Port Lavaca Dentistry Pllc is 1 of 9237 dentist organizations in Texas.
Primary specialty
Dentist
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Lopez
Payer Enrollment Team Lead
Last NPPES update
2025-12-04
Source: monthly bulk 2026-05
How this organization compares
Across 9237 active dentist providers in Texas.
NPI age
12 years
≈ at median (12 yr)
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2014 → 2026
2014-05Enumerated in NPPES
2014
2026
Where they practice
Primary practice location
1606 N Virginia St
Port Lavaca, TX 77979
Mailing address
Attn: Credentialing, 2403 Lacy Lane
Carrollton, TX 75006
Authorized official
Paola Lopez
Payer Enrollment Team Lead
📞 9728693789
Individual providers at this organization
2 individual providers on file at this primary practice address.
- Bryce O'Donnell, DDS Dentist NPI 1154056927
- Richard Terasaki, D.D.S. Dentist NPI 1386650307
Specialties
-
Dentist PrimaryA dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two...
Practice context
Multi-provider organization. 2 individual providers on file at this primary address.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Verify the organization is in good standing.Cross-check with the state's business registration and any applicable licensing boards.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.