Outreach for Smiles, PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

11436 Issued in TX

Legal business name

OUTREACH FOR SMILES, PLLC

Practice address

4047 Stahl Rd Ste 1
San Antonio, TX 78217-1670

Phone

(210) 566-8668

NPI assigned

Sep 5, 2011

Last updated

Sep 5, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dan Marcuse, DDS

Title

Owner

Phone

(210) 412-5798

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1315180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315180800000",
    "number": "1093096059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4047 STAHL RD STE 1",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782171670",
            "telephone_number": "210-566-8668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4047 STAHL RD STE 1",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782171670",
            "telephone_number": "210-566-8668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OUTREACH FOR SMILES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-05",
        "last_updated": "2011-09-05",
        "status": "A",
        "authorized_official_last_name": "MARCUSE",
        "authorized_official_first_name": "DAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "210-412-5798",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "11436",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1760628010",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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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 Sep 5, 2011; 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.