Geriatric Dental Group of South Texas, PA

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

16152 Issued in TX

Legal business name

GERIATRIC DENTAL GROUP OF SOUTH TEXAS, PA

Practice address

5282 Medical Dr Ste 104
San Antonio, TX 78229-4983

Phone

(210) 617-4446

Fax

(210) 617-5572

NPI assigned

Jul 28, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Sarah June Dirks, DDS

Title

Owner/President

Phone

(210) 617-4446

Specialties & licenses 1

Addresses

Other names 1

• Sarah J Dirks, DDS Former legal business name

Locations

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

{
    "created_epoch": "1406505600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406505600000",
    "number": "1245648732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5282 MEDICAL DR STE 104",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782294983",
            "telephone_number": "210-617-4446",
            "fax_number": "210-617-5572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5282 MEDICAL DR STE 104",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782294983",
            "telephone_number": "210-617-4446",
            "fax_number": "210-617-5572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GERIATRIC DENTAL GROUP OF SOUTH TEXAS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-28",
        "last_updated": "2014-07-28",
        "status": "A",
        "authorized_official_last_name": "DIRKS",
        "authorized_official_first_name": "SARAH",
        "authorized_official_middle_name": "JUNE",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "210-617-4446",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "TX",
            "license": "16152",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sarah J Dirks, DDS",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Christopher Allen Gerhart, PT, DPT
• Coltin Roq Brodrick Gerhart, MD
• Geriatric and Palliative Medical Care of Texas LLC
• Geriatric and Physical Therapy of San Antonio PLLC
• Geriatric Community Hospice Care of Texas LLC
• Geriatric Mental Health Specialists Inc.
• Geriatric Vision Services
• Darrell Gerik
• Susan Marie Gerik
• Sujatha Gerineni, MD

• 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 Jul 28, 2014; 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.