Organization Active NPI

Bulverde Dental Specialist PLLC

  • General Practice Dentistry
  • San Antonio, TX
National Provider Identifier
1295344679
Registry record updated Jul 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
BULVERDE DENTAL SPECIALIST PLLC
Practice address
22103 Bulverde Rd Ste 108
San Antonio, TX 78259-1855
Phone
(210) 907-8666
NPI assigned
Jul 30, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2020

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

Authorized official

Name
Yunhan Ding, DDS
Title
Operating Member
Phone
(210) 867-7489

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223X0400X

Addresses

Primary practice location

22103 Bulverde Rd Ste 108
San Antonio, TX 78259-1855

Mailing address

22103 Bulverde Rd Ste 108
San Antonio, TX 78259-1855

Other names 1

  • Smiles of Bulverde Doing business as

National Provider Directory

National Provider Directory

Locations

22103 Bulverde Rd
Ste 108
San Antonio, TX 78259
Phone (210) 907-8666

Practitioners & affiliated clinicians

Practitioners 1

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": "1596067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596067200000",
    "number": "1295344679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22103 BULVERDE RD STE 108",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782591855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22103 BULVERDE RD STE 108",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782591855",
            "telephone_number": "210-907-8666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BULVERDE DENTAL SPECIALIST PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-30",
        "last_updated": "2020-07-30",
        "certification_date": "2020-07-30",
        "status": "A",
        "authorized_official_last_name": "DING",
        "authorized_official_first_name": "YUNHAN",
        "authorized_official_title_or_position": "OPERATING MEMBER",
        "authorized_official_telephone_number": "210-867-7489",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Smiles of Bulverde",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jul 30, 2020; 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.