San Angelo Endodontics, PC

Primary specialty

EndodonticsTaxonomy code 1223E0200X

Legal business name

SAN ANGELO ENDODONTICS, PC

Practice address

2014 W Beauregard Ave
San Angelo, TX 76901-3813

Phone

(325) 947-3040

Fax

(806) 797-2460

NPI assigned

Mar 6, 2019

Organization subpart

No

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

Authorized official

Name

Mr. Chad R Southard, FACHE, FHFMA

Title

Administrator

Phone

(806) 797-4455

Specialties & licenses 1

Addresses

Other names 1

• Concho Valley Endodontics Doing business as

Locations

Practitioners 1

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

• James McIntosh, DDS

  • Endodontics
  • Abilene, TX
  • NPI 1265039663
  NPD (past)

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

{
    "created_epoch": "1551830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551830400000",
    "number": "1174081301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2014 W BEAUREGARD AVE",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769013813",
            "telephone_number": "325-947-3040",
            "fax_number": "806-797-2460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2014 W BEAUREGARD AVE",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769013813",
            "telephone_number": "325-947-3040",
            "fax_number": "806-797-2460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN ANGELO ENDODONTICS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-06",
        "last_updated": "2019-03-06",
        "status": "A",
        "authorized_official_last_name": "SOUTHARD",
        "authorized_official_first_name": "CHAD",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "806-797-4455",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "FACHE, FHFMA"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Concho Valley Endodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• San Angelo Ambulatory Surgery Center
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• San Angelo Cardiovascular Center of Excellence, PLLC
• San Angelo Emergency Medicine Associates PA
• San Angelo Emergency Physicians
• San Angelo ER LLC
• San Angelo Health Care, LLC
• San Angelo Hospital LP
• San Angelo Hospital LP
• San Angelo Hospital, LP

• Endodontics in San Angelo, TX
• Providers in San Angelo, TX by specialty
• Endodontics in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2019; 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.