NPIMap

Organization Active NPI

Summit Dental Center, L.P.

  • General Practice Dentistry
  • San Antonio, TX
National Provider Identifier
1275920563
Registry record updated Apr 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
17989 Issued in TX
Legal business name
SUMMIT DENTAL CENTER, L.P.
Practice address
3949 Fredericksburg Rd
San Antonio, TX 78201-3231
Phone
(210) 785-8555
Fax
(210) 785-8300
NPI assigned
Apr 24, 2015
Last updated
Apr 24, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2015

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

Authorized official

Name
Dr. Essa A Kawaja Sr., DDSNPI 1730240300
Title
Dentist/Owner
Phone
(832) 673-0999

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 17989 TX Primary

Addresses

Primary practice location

3949 Fredericksburg Rd
San Antonio, TX 78201-3231

Mailing address

1812 Durham Dr
Suite a
Houston, TX 77007-2256
Phone (832) 673-0999

Other identifiers 1

IdentifierTypeStateIssuer
193400000XOtherTXDENTAL

National Provider Directory

National Provider Directory
Tax ID family
Summit Dental Center LP12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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

Locations

3949 Fredericksburg Rd
San Antonio, TX 78201
Phone (210) 265-3361

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1429833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429833600000",
    "number": "1275920563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1812 DURHAM DR",
            "address_2": "SUITE A",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770072256",
            "telephone_number": "832-673-0999",
            "fax_number": "281-657-2406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3949 FREDERICKSBURG RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782013231",
            "telephone_number": "210-785-8555",
            "fax_number": "210-785-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT DENTAL CENTER, L.P.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-24",
        "last_updated": "2015-04-24",
        "status": "A",
        "authorized_official_last_name": "KAWAJA",
        "authorized_official_first_name": "ESSA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "832-673-0999",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "17989",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL",
            "identifier": "193400000X",
            "state": "TX"
        }
    ],
    "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 24, 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.