NPIMap

Organization Active NPI

Lost Creek Dental

  • General Practice Dentistry
  • San Antonio, TX
National Provider Identifier
1265829188
Registry record updated Apr 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
LOST CREEK DENTAL
Practice address
11919 Culebra Rd
BLDG 2
San Antonio, TX 78253
Phone
(210) 688-0332
Fax
(210) 688-0333
NPI assigned
Apr 17, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2015

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

Authorized official

Name
Mrs. Laura Carson
Title
Office Manager
Phone
(210) 688-0332

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

11919 Culebra Rd
BLDG 2
San Antonio, TX 78253

Mailing address

11919 Culebra Rd.
BLDG 2
San Antonio, TX 78253
Phone (210) 688-0332

National Provider Directory

National Provider Directory
Tax ID family
Lost Creek Dental2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

11919 Culebra Rd
Bldg 2
San Antonio, TX 78253
Phone (210) 688-0332

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": "1429228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429228800000",
    "number": "1265829188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11919 CULEBRA RD.",
            "address_2": "BLDG 2",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78253",
            "telephone_number": "210-688-0332",
            "fax_number": "210-688-0333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11919 CULEBRA RD",
            "address_2": "BLDG 2",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78253",
            "telephone_number": "210-688-0332",
            "fax_number": "210-688-0333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOST CREEK DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-17",
        "last_updated": "2015-04-17",
        "status": "A",
        "authorized_official_last_name": "CARSON",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "210-688-0332",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "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 Apr 17, 2015; 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.