# BERNARDINO OCTAVIO ELIZONDO D.D.S. P.C.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Sunshine Family Dentistry
- **Organization subpart:** No

## Provider details

- **NPI number:** 1851404420
- **Authorized official:** DR. BERNARDINO OCTAVIO ELIZONDO D.D.S. (OWNER/ PRESIDENT)
- **Authorized official phone:** (956) 399-9929

## Contact information

- **Practice address:** 1389 W US HIGHWAY 77, SUITE E, SAN BENITO, TX 78586-4161
- **Practice address phone:** (956) 399-9929
- **Practice address fax:** (956) 399-4855
- **Mailing address:** 1389 W US HIGHWAY 77, SUITE E, SAN BENITO, TX 78586-4161
- **Mailing address phone:** (956) 399-9929
- **Mailing address fax:** (956) 399-4855

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 19338 | TX | Yes |

## Other

- **Enumeration date:** 08/16/2006
- **Last updated:** 04/23/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 155609401 | — | TX |
| 01 | — | G60092-01 | TEXAS CHIP | TX |