Active NPI
Mary Ann Douthit, D.D.S.
- Dentist
- San Antonio, TX
National Provider Identifier
1326067760
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 15308
- Practice address
- 10615 Perrin Beitel Rd
Ste. 103
San Antonio, TX 78217-3138 - Phone
- (210) 646-8818
- Fax
- (210) 646-8878
- NPI assigned
- Jul 18, 2006
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 15308 | TX | Primary |
Addresses
Primary practice location
10615 Perrin Beitel Rd
Ste. 103
San Antonio, TX 78217-3138
Mailing address
10615 Perrin Beitel Rd
Ste. 103
San Antonio, TX 78217-3138
Phone (210) 646-8818
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 689825 | Other | TX | UNITED CONCORDIA PROVIDER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15308 | TX | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1326067760",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10615 PERRIN BEITEL RD",
"address_2": "STE. 103",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782173138",
"telephone_number": "210-646-8818",
"fax_number": "210-646-8878"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10615 PERRIN BEITEL RD",
"address_2": "STE. 103",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782173138",
"telephone_number": "210-646-8818",
"fax_number": "210-646-8878"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOUTHIT",
"first_name": "MARY",
"middle_name": "ANN",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "15308",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED CONCORDIA PROVIDER",
"identifier": "689825",
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.