Kusom Dental Broadway PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

KUSOM DENTAL BROADWAY PLLC

Practice address

8852 Broadway # 201
San Antonio, TX 78217-6318

Phone

(210) 888-0700

NPI assigned

Oct 27, 2023

Organization subpart

No

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

Authorized official

Name

Selinda Gonzalez

Title

Office Manager

Phone

(210) 888-0700

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1698364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716163200000",
    "number": "1265204622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18707 HARDY OAK BLVD STE 305",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782584895",
            "telephone_number": "210-888-0700",
            "fax_number": "210-625-7398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8852 BROADWAY # 201",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782176318",
            "telephone_number": "210-888-0700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KUSOM DENTAL BROADWAY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-27",
        "last_updated": "2024-05-20",
        "certification_date": "2024-05-20",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "SELINDA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "210-888-0700"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steven Marc Kurtzman, MD
• Isanely Guerrero Kurz, LPC
• Marisol Kusbel, D.D.S
• Leann Kuser, PHARMD
• Melissa Kushnick
• Kusom Pediatric Dental South PLLC
• Ashleigh Marie Kussman, M.D.
• Alexi Kutac
• Marion Kutac
• Kutik-Giampaolo Hearing, Inc.

• General Practice Dentistry in San Antonio, TX
• Providers in San Antonio, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2024; 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.