Individual provider Active NPI

Tala Ahmad Nassar

  • Dentist
  • San Antonio, TX
National Provider Identifier
1265344758
Registry record updated Sep 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
42658 Issued in TX
Practice address
13909 Nacogdoches Rd Ste 113a
San Antonio, TX 78217-1296
Phone
(210) 590-4100
NPI assigned
Sep 19, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 19, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 42658 TX Primary

Addresses

Primary practice location

13909 Nacogdoches Rd Ste 113a
San Antonio, TX 78217-1296

Mailing address

210 W Josephine St Apt 1236
San Antonio, TX 78212-4715

Other practice location 1

916 Coronado Blvd
Universal City, TX 78148-3226
Phone (210) 775-5177

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1789776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789776000000",
    "number": "1265344758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 W JOSEPHINE ST APT 1236",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782124715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13909 NACOGDOCHES RD STE 113A",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782171296",
            "telephone_number": "210-590-4100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "916 Coronado Blvd",
            "address_purpose": "LOCATION",
            "city": "Universal City",
            "state": "TX",
            "postal_code": "781483226",
            "country_code": "US",
            "telephone_number": "210-775-5177",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NASSAR",
        "first_name": "TALA",
        "middle_name": "AHMAD",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-09-19",
        "last_updated": "2026-09-19",
        "certification_date": "2026-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "42658",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Sep 19, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.