NPIMap

Organization Active NPI

Dental Republic Plaza PC

  • Dental Clinic/Center
  • San Antonio, TX
National Provider Identifier
1033858006
Registry record updated May 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
DENTAL REPUBLIC PLAZA PC
Practice address
11535 West Ave
San Antonio, TX 78213-1343
Phone
(210) 780-6000
NPI assigned
May 30, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 30, 2022

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

Authorized official

Name
Mr. Son Tran, DDSNPI 1316163546
Title
President
Phone
(972) 747-1400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

11535 West Ave
San Antonio, TX 78213-1343

Mailing address

3211 W Northwest Hwy # 100
Dallas, TX 75220-5944
Phone (972) 747-1400

Other names 1

  • Dental Republic West Ave Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address credentialing@purechart.com Direct

National Provider Directory

National Provider Directory

Locations

11535 West Ave
San Antonio, TX 78213
Phone (210) 366-0100

Practitioners & affiliated clinicians

Practitioners 1

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": "1653868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653868800000",
    "number": "1033858006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3211 W NORTHWEST HWY # 100",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752205944",
            "telephone_number": "972-747-1400",
            "fax_number": "214-242-4455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11535 WEST AVE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782131343",
            "telephone_number": "210-780-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL REPUBLIC PLAZA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-30",
        "last_updated": "2022-05-30",
        "certification_date": "2022-05-30",
        "status": "A",
        "authorized_official_last_name": "TRAN",
        "authorized_official_first_name": "SON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "972-747-1400",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "credentialing@purechart.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "11535 West Ave",
            "city": "San Antonio",
            "state": "TX",
            "country_code": "US",
            "postal_code": "782131343",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Dental Republic West Ave",
            "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 May 30, 2022; 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.