NPIMap

Organization Active NPI

Serapio de la Rosa Jr, D.D.S., P.C.

  • General Practice Dentistry
  • San Antonio, TX
National Provider Identifier
1134429129
Registry record updated Nov 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
14393 Issued in TX
Legal business name
SERAPIO DE LA ROSA JR, D.D.S., P.C.
Practice address
7720 Jones Maltsberger Rd
Suite 105
San Antonio, TX 78216-6993
Phone
(210) 804-2212
Fax
(210) 804-2355
NPI assigned
Oct 25, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2010

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

Authorized official

Name
Dr. Serapio De la Rosa Jr., DDS
Title
Dentist/Owner
Phone
(210) 804-2212

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 14393 TX Primary

Addresses

Primary practice location

7720 Jones Maltsberger Rd
Suite 105
San Antonio, TX 78216-6993

Mailing address

7720 Jones Maltsberger Rd
Suite 105
San Antonio, TX 78216-6993
Phone (210) 804-2212

Other identifiers 2

IdentifierTypeStateIssuer
198199501MedicaidTX
111234402MedicaidTX

Other names 1

  • All Smiles Dental Center Doing business as

National Provider Directory

National Provider Directory

Locations

7720 Jones Maltsberger Rd
Ste 105
San Antonio, TX 78216
Phone (210) 804-2212

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1287964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289520000000",
    "number": "1134429129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7720 JONES MALTSBERGER RD",
            "address_2": "SUITE 105",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782166993",
            "telephone_number": "210-804-2212",
            "fax_number": "210-804-2355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7720 JONES MALTSBERGER RD",
            "address_2": "SUITE 105",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782166993",
            "telephone_number": "210-804-2212",
            "fax_number": "210-804-2355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERAPIO DE LA ROSA JR, D.D.S., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-25",
        "last_updated": "2010-11-12",
        "status": "A",
        "authorized_official_last_name": "DE LA ROSA",
        "authorized_official_first_name": "SERAPIO",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "210-804-2212",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "14393",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "198199501",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111234402",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "All Smiles Dental Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Nov 12, 2010; 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.