NPIMap

Organization Active NPI

Brident Dental Associates PC

  • Dentist
  • San Antonio, TX
National Provider Identifier
1033683131
Registry record updated Jan 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
BRIDENT DENTAL ASSOCIATES PC
Practice address
3655 Fredericksburg Rd Ste 112
San Antonio, TX 78201-3859
Phone
(210) 733-9990
Fax
(210) 731-8877
NPI assigned
Jan 11, 2019
Last updated
Jan 11, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2019

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

Authorized official

Name
Maribel Zamora
Title
Enrollment Coordinator
Phone
(714) 571-3104

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X NU Primary

Addresses

Primary practice location

3655 Fredericksburg Rd Ste 112
San Antonio, TX 78201-3859

Mailing address

530 S Main St Ste 600
Orange, CA 92868-4544
Phone (714) 480-3000

Other identifiers 1

IdentifierTypeStateIssuer
G60850MedicaidTX

National Provider Directory

National Provider Directory
Tax ID family
Brident Dental Associates PC44 organizations share this tax ID, including this one

Other organizations with this tax ID 43

Organizations that report the same tax identification number in the National Provider Directory.

View all 43

Locations

3655 Fredericksburg Rd
Ste 112
San Antonio, TX 78201
Phone (210) 733-9990

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1547164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1547164800000",
    "number": "1033683131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 S MAIN ST STE 600",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684544",
            "telephone_number": "714-480-3000",
            "fax_number": "714-571-6445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3655 FREDERICKSBURG RD STE 112",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782013859",
            "telephone_number": "210-733-9990",
            "fax_number": "210-731-8877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDENT DENTAL ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-11",
        "last_updated": "2019-01-11",
        "status": "A",
        "authorized_official_last_name": "ZAMORA",
        "authorized_official_first_name": "MARIBEL",
        "authorized_official_title_or_position": "ENROLLMENT COORDINATOR",
        "authorized_official_telephone_number": "714-571-3104"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G60850",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Jan 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.