Mission Plaza Dental PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

22951 Issued in TX

Legal business name

MISSION PLAZA DENTAL PLLC

Practice address

3454 Roosevelt Ave.
San Antonio, TX 78214

Phone

(210) 546-1337

Fax

(210) 546-1348

NPI assigned

Jun 2, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Andrew Thomas Scraver, DDS

Title

Owner

Phone

(210) 546-1337

Specialties & licenses 1

Addresses

Other names 1

• Smile Structure Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Adam Leslie Smith, D.D.S.

  • General Practice Dentistry
  • San Antonio, TX
  • NPI 1376774133
  NPD (past)
• Lauren Spathias, DMD

  • Dentist
  • Dothan, AL
  • NPI 1821646134
  NPD (past)

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

{
    "created_epoch": "1306972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1306972800000",
    "number": "1104110501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3454 ROOSEVELT AVE.",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78214",
            "telephone_number": "210-546-1337",
            "fax_number": "210-546-1348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3454 ROOSEVELT AVE.",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78214",
            "telephone_number": "210-546-1337",
            "fax_number": "210-546-1348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSION PLAZA DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-02",
        "last_updated": "2011-06-02",
        "status": "A",
        "authorized_official_last_name": "SCRAVER",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "210-546-1337",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "22951",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Smile Structure",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mission Event Senior Center LLC
• Mission HHH LLC
• Mission Hospice Care LLC
• Mission MRI, LLC
• Mission Oaks 7To7 PLLC
• Mission Plus Healthcare LLC
• Mission Rehabilitation and Sports Medicine Limited Partnership
• Mission Rehabilitation and Sports Medicine Limited Partnership
• Mission Rehabilitation and Sports Medicine Limited Partnership
• Mission Rehabilitation and Sports Medicine Limited Partnership

• 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 Jun 2, 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.