Access Dental of Fredericksburg PA

Primary specialty

DentistTaxonomy code 122300000X

License

22334 Issued in TX

Legal business name

ACCESS DENTAL OF FREDERICKSBURG PA

Practice address

4315 Fredericksburg Balcones Height
100A
San Antonio, TX 78201

Phone

(972) 514-1672

NPI assigned

Sep 6, 2016

Organization subpart

No

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

Authorized official

Name

Tien Dinh Phan, DMD

Title

Ceo

Phone

(972) 514-1672

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1473120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473120000000",
    "number": "1093262172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 W WALNUT HILL LN",
            "address_2": "3950",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750383029",
            "telephone_number": "972-514-1672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4315 FREDERICKSBURG BALCONES HEIGHT",
            "address_2": "100A",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78201",
            "telephone_number": "972-514-1672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACCESS DENTAL OF FREDERICKSBURG PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-06",
        "last_updated": "2016-09-06",
        "status": "A",
        "authorized_official_last_name": "PHAN",
        "authorized_official_first_name": "TIEN",
        "authorized_official_middle_name": "DINH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "972-514-1672",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "TX",
            "license": "22334",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Academy of Careers and Technologies, Inc.
• Acadian Ambulance Service of Texas LLC
• Accent Plastic Surgery PA
• Accentcare Inc
• Access Dental of Commerce, P.a.
• Access Dental of Pleasanton, P.a.
• Access Dental of West, P.a.
• Access Dental of White, P.a.
• Access Dental of Zarzamora PA
• Access Healthcare Services PLLC

• All providers in San Antonio, TX
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 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.