Tooth Acres Inc

Primary specialty

DentistTaxonomy code 122300000X

License

14065 Issued in TX

Legal business name

TOOTH ACRES INC

Practice address

2635 Nacogdoches Rd
San Antonio, TX 78217

Phone

(210) 829-7651

Fax

(210) 829-4604

NPI assigned

Aug 31, 2006

Organization subpart

No

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

Authorized official

Name

Barry Weyman Holleron, DDS

Title

President

Phone

(210) 829-7651

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1306958020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2635 NACOGDOCHES RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78217",
            "telephone_number": "210-829-7651",
            "fax_number": "210-829-4604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2635 NACOGDOCHES RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78217",
            "telephone_number": "210-829-7651",
            "fax_number": "210-829-4604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOOTH ACRES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HOLLERON",
        "authorized_official_first_name": "BARRY",
        "authorized_official_middle_name": "WEYMAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "210-829-7651",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "TX",
            "license": "14065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in San Antonio, TX
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• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.