Individual provider Active NPI

Ajai Pilla

  • General Practice Dentistry
  • San Antonio, TX
National Provider Identifier
1083391072
Registry record updated Jun 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
39636 Issued in TX
Practice address
6810 Bandera Rd
San Antonio, TX 78238-1377
Phone
(210) 686-0737
NPI assigned
Jun 30, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 39636 TX Primary

Addresses

Primary practice location

6810 Bandera Rd
San Antonio, TX 78238-1377

Mailing address

6810 Bandera Rd
San Antonio, TX 78238-1377

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
39636TXMDSpeech-Language Assistant

NPI Registry JSON

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

{
    "created_epoch": "1688083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688083200000",
    "number": "1083391072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6810 BANDERA RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782381377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6810 BANDERA RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782381377",
            "telephone_number": "210-686-0737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PILLA",
        "first_name": "AJAI",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-30",
        "last_updated": "2023-06-30",
        "certification_date": "2023-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "39636",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jun 30, 2023; 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.