Cibolo Modern Dentistry, PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

CIBOLO MODERN DENTISTRY, PC

Practice address

813 Cibolo Valley Dr Ste 130
Cibolo, TX 78108-4558

Phone

(210) 996-2221

NPI assigned

May 6, 2024

Organization subpart

No

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

Authorized official

Name

Claudia Samaniego

Title

Owner

Phone

(714) 845-8500

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1714953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714953600000",
    "number": "1346097433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 920050",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753920050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "813 CIBOLO VALLEY DR STE 130",
            "city": "CIBOLO",
            "state": "TX",
            "postal_code": "781084558",
            "telephone_number": "210-996-2221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CIBOLO MODERN DENTISTRY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-06",
        "last_updated": "2024-05-06",
        "certification_date": "2024-05-06",
        "status": "A",
        "authorized_official_last_name": "SAMANIEGO",
        "authorized_official_first_name": "CLAUDIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "714-845-8500"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Yolanda Lynn Cockfield, SPEECH THERAPIST
• Julia Marie Conn, BCBA, LBA

• All providers in Cibolo, TX
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2024; 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.