Organization Active NPI

Jurich Brothers PLLC

  • General Practice Dentistry
  • San Antonio, TX
National Provider Identifier
1013739143
Registry record updated Oct 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
JURICH BROTHERS PLLC
Practice address
1804 Buena Vista St
San Antonio, TX 78207-3805
Phone
(210) 227-9921
Fax
(210) 223-4081
NPI assigned
Oct 29, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Melanie Rodriguez
Title
Front Office
Phone
(210) 227-9921

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

1804 Buena Vista St
San Antonio, TX 78207-3805

Mailing address

1804 Buena Vista St
San Antonio, TX 78207-3805
Phone (210) 227-9921

Other names 1

  • JURICH DENTAL BUENA VISTA Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241206000879 TX Part B Supplier - Clinic/Group Practice 2163958711 Receives reassigned benefits from 1 practitioner
Practice locations: San Antonio, TX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1730160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730160000000",
    "number": "1013739143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1804 BUENA VISTA ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782073805",
            "telephone_number": "210-227-9921",
            "fax_number": "210-223-4081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1804 BUENA VISTA ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782073805",
            "telephone_number": "210-227-9921",
            "fax_number": "210-223-4081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JURICH BROTHERS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-29",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-29",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ",
        "authorized_official_first_name": "MELANIE",
        "authorized_official_title_or_position": "FRONT OFFICE",
        "authorized_official_telephone_number": "210-227-9921"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JURICH DENTAL BUENA VISTA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.