NPIMap

Organization Active NPI

Cam Janse D.D.S. P.C

  • General Practice Dentistry
  • San Antonio, TX
National Provider Identifier
1164430401
Registry record updated Apr 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
13898 Issued in TX
Legal business name
CAM JANSE D.D.S. P.C
Practice address
9820 Braun Rd
Suite #102
San Antonio, TX 78254
Phone
(210) 523-2400
NPI assigned
Aug 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2009

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

Authorized official

Name
Dr. Campbell Riddick Janse, D.D.S.
Title
Owner
Phone
(210) 523-2400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 13898 TX Primary

Addresses

Primary practice location

9820 Braun Rd
Suite #102
San Antonio, TX 78254

Mailing address

9820 Braun Rd
Suite #102
San Antonio, TX 78254
Phone (210) 523-2400

Other identifiers 3

IdentifierTypeStateIssuer
1208456-04MedicaidTX
551692OtherTXUNITED CONCORDIA
1D3898OtherTXBLUE CROSS BLUE SHIELD

National Provider Directory

National Provider Directory
Tax ID family
Braun Family Dental2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

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": "1154563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1239753600000",
    "number": "1164430401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9820 BRAUN RD",
            "address_2": "SUITE #102",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78254",
            "telephone_number": "210-523-2400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9820 BRAUN RD",
            "address_2": "SUITE #102",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78254",
            "telephone_number": "210-523-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAM JANSE D.D.S. P.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-03",
        "last_updated": "2009-04-15",
        "status": "A",
        "authorized_official_last_name": "JANSE",
        "authorized_official_first_name": "CAMPBELL",
        "authorized_official_middle_name": "RIDDICK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "210-523-2400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "13898",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1208456-04",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "551692",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "1D3898",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Apr 15, 2009; 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.