The Original Bulverde Dental Office, PA

Primary specialty

DentistTaxonomy code 122300000X

License

20998 Issued in TX

Legal business name

THE ORIGINAL BULVERDE DENTAL OFFICE, PA

Practice address

2395 Bulverde Rd
#103
Bulverde, TX 78163

Phone

(830) 980-2869

Fax

(830) 438-3363

NPI assigned

Nov 27, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Carey Snider

Title

Office Assistant

Phone

(830) 980-2869

Specialties & licenses 1

Addresses

Other names 1

• Bulverde Dental Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Guy E Peterson, DDS

  • Dentist
  • Bulverde, TX
  • NPI 1821246695
  NPD (past)

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

{
    "created_epoch": "1164585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257724800000",
    "number": "1265508956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2395 BULVERDE RD",
            "address_2": "#103",
            "city": "BULVERDE",
            "state": "TX",
            "postal_code": "78163",
            "telephone_number": "830-980-2869",
            "fax_number": "830-438-3363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2395 BULVERDE RD",
            "address_2": "#103",
            "city": "BULVERDE",
            "state": "TX",
            "postal_code": "78163",
            "telephone_number": "830-980-2869",
            "fax_number": "830-438-3363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE ORIGINAL BULVERDE DENTAL OFFICE, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-27",
        "last_updated": "2009-11-09",
        "status": "A",
        "authorized_official_last_name": "SNIDER",
        "authorized_official_first_name": "CAREY",
        "authorized_official_title_or_position": "OFFICE ASSISTANT",
        "authorized_official_telephone_number": "830-980-2869",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "TX",
            "license": "20998",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bulverde Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Madeline Oines Thomas
• Kassandra Grace Thompson, M.S., LPC, NCC
• Ryane Thurman
• Dana Lynn Tiller, LPC
• Alexandra Toala

• Dentist in Bulverde, TX
• Providers in Bulverde, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2009; 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.