NPIMap

Organization Active NPI

9590 Marbach San Antonio Services, PLLC

Doing business as Heritage Dental

  • Dentist
  • San Antonio, TX
National Provider Identifier
1215493697
Registry record updated Feb 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
9590 MARBACH SAN ANTONIO SERVICES, PLLC
Doing business as
Heritage Dental
Practice address
9590 Marbach Rd
San Antonio, TX 78245-1825
Phone
(210) 673-9051
NPI assigned
Feb 11, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2019

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

Authorized official

Name
Dr. Peter C Grumbos, DDS
Title
Owner
Phone
(972) 360-9944

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

9590 Marbach Rd
San Antonio, TX 78245-1825

Mailing address

9590 Marbach Rd
San Antonio, TX 78245-1825

Other names 1

  • Heritage Dental Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1549843200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1549843200000",
    "number": "1215493697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9590 MARBACH RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782451825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9590 MARBACH RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782451825",
            "telephone_number": "210-673-9051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "9590 MARBACH SAN ANTONIO SERVICES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-11",
        "last_updated": "2019-02-11",
        "status": "A",
        "authorized_official_last_name": "GRUMBOS",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "972-360-9944",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heritage Dental",
            "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 Feb 11, 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.