Individual provider Active NPI

Zeth Jurich, DMD

  • General Practice Dentistry
  • San Antonio, TX
National Provider Identifier
1275218208
Registry record updated Oct 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
39689 Issued in TX
Practice address
1804 Buena Vista St
San Antonio, TX 78207-3805
Phone
(210) 227-9921
Fax
(210) 223-4081
NPI assigned
Jun 19, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 39689 TX Primary

Addresses

Primary practice location

1804 Buena Vista St
San Antonio, TX 78207-3805

Mailing address

21375 County Road 174
Helotes, TX 78023-2409

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241206000997 TX Practitioner - Dentist 3072049626 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
39689TXMDPharmacotherapy Pharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Jurich Brothers PLLC General Practice CurrentSince Oct 29, 2024 Accepting new patients
Dr. Richard P. Anderson DDS. Inc General Practice PastSince Nov 3, 2024 Accepting new patients

Locations

1804 Buena Vista St
San Antonio, TX 78207
Phone (210) 227-9921

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1687132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730073600000",
    "number": "1275218208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21375 COUNTY ROAD 174",
            "city": "HELOTES",
            "state": "TX",
            "postal_code": "780232409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1804 BUENA VISTA ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782073805",
            "telephone_number": "210-227-9921",
            "fax_number": "210-223-4081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JURICH",
        "first_name": "ZETH",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-19",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "39689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.