San Marcos Dental and Braces PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

SAN MARCOS DENTAL AND BRACES PLLC

Practice address

102 Wonder World Dr Ste 101
San Marcos, TX 78666-6080

Phone

(210) 944-0504

NPI assigned

Nov 6, 2023

Organization subpart

No

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

Authorized official

Name

Rosa Wolfford

Title

Credentialing Specialist

Phone

(210) 568-9800

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1699228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699833600000",
    "number": "1336912864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 849",
            "city": "JASPER",
            "state": "TX",
            "postal_code": "759510010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 WONDER WORLD DR STE 101",
            "city": "SAN MARCOS",
            "state": "TX",
            "postal_code": "786666080",
            "telephone_number": "210-944-0504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN MARCOS DENTAL AND BRACES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-06",
        "last_updated": "2023-11-13",
        "certification_date": "2023-11-13",
        "status": "A",
        "authorized_official_last_name": "WOLFFORD",
        "authorized_official_first_name": "ROSA",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "210-568-9800"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sams East Inc (Sams Pharmacy)
• San Marcos Anesthesiology, LLP
• San Marcos ASC LLC
• San Marcos Cisd
• San Marcos Cisd
• San Marcos Diagnostics PA
• San Marcos DSG PLLC
• San Marcos Ear Nose & Throat Association
• San Marcos Family Medicine
• San Marcos Gentle Dental, PLLC

• Dental Clinic/Center in San Marcos, TX
• Providers in San Marcos, TX by specialty
• Dental Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2023; 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.