SD- Potranco, PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

19887 Issued in TX

Legal business name

SD- POTRANCO, PC

Practice address

9530 Potranco Rd
San Antonio, TX 78251-9601

Phone

(210) 670-9000

Fax

(210) 681-6657

NPI assigned

Oct 21, 2016

Organization subpart

No

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

Authorized official

Name

Lynhthy Thy Pham, DDS

Title

President

Phone

(214) 466-1400

Specialties & licenses 1

Addresses

Other names 1

• SMILEY DENTAL Doing business as

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

{
    "created_epoch": "1477008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477008000000",
    "number": "1063963387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10901 GARLAND RD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752182613",
            "telephone_number": "214-466-1400",
            "fax_number": "214-367-5896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9530 POTRANCO RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782519601",
            "telephone_number": "210-670-9000",
            "fax_number": "210-681-6657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SD- POTRANCO, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-21",
        "last_updated": "2016-10-21",
        "status": "A",
        "authorized_official_last_name": "PHAM",
        "authorized_official_first_name": "LYNHTHY",
        "authorized_official_middle_name": "THY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "214-466-1400",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "19887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SMILEY DENTAL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Dentistry in San Antonio, TX
• Providers in San Antonio, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2016; 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.