Elizabeth Mattsson DDS PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

23987 Issued in TX

Legal business name

ELIZABETH MATTSSON DDS PLLC

Practice address

1202 E Sonterra Blvd Ste 502
San Antonio, TX 78258-4092

Phone

(210) 349-3715

NPI assigned

Jun 23, 2016

Last updated

Jun 23, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Elizabeth Mattsson, DDSNPI 1104071794

Title

Owner

Phone

(210) 349-3715

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Elizabeth Dominique Mattsson, DDS

  • General Practice Dentistry
  • San Antonio, TX
  • NPI 1104071794
  NPD (past) Authorized official

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

{
    "created_epoch": "1466640000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466640000000",
    "number": "1215388020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1202 E SONTERRA BLVD STE 502",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782584092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1202 E SONTERRA BLVD STE 502",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782584092",
            "telephone_number": "210-349-3715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELIZABETH MATTSSON DDS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-23",
        "last_updated": "2016-06-23",
        "status": "A",
        "authorized_official_last_name": "MATTSSON",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "210-349-3715",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "TX",
            "license": "23987",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL LICENSE",
            "identifier": "23987",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashley Kimtashi Elix, AGACNP-BC
• Elizabeth Bohnenblust Clanton, MD, PA
• Elizabeth Hughes Dermatology PLLC
• Elizabeth L. Mitchell MD PA
• Elizabeth Loudon, MD PA
• Elizabeth Shelby Walter PLLC
• Angelica Maria Elizalde
• Araceli Elizalde, MD
• Alyssa Elizardo
• Justice Elizardo

• Dental Clinic/Center in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Dental Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2016; 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.