West Culebra Dental PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

26562 Issued in TX

Legal business name

WEST CULEBRA DENTAL PLLC

Practice address

5835 Culebra Rd
Suite 105
San Antonio, TX 78228-4354

Phone

(940) 368-1495

NPI assigned

Jul 20, 2015

Organization subpart

No

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

Authorized official

Name

Mr. Darren Earl Boggs

Title

Chief Operating Officer

Phone

(940) 368-1495

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1437350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437350400000",
    "number": "1144604166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1308 TEASLEY LN",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762057946",
            "telephone_number": "254-717-8469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5835 CULEBRA RD",
            "address_2": "SUITE 105",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782284354",
            "telephone_number": "940-368-1495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST CULEBRA DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-20",
        "last_updated": "2015-07-20",
        "status": "A",
        "authorized_official_last_name": "BOGGS",
        "authorized_official_first_name": "DARREN",
        "authorized_official_middle_name": "EARL",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "940-368-1495",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "26562",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jul 20, 2015; 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.