Cibolo Pediatric Dentistry, PLLC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

CIBOLO PEDIATRIC DENTISTRY, PLLC

Practice address

3738 Cibolo Valley Dr.
Cibolo, TX 78108

Phone

(830) 772-4200

NPI assigned

May 31, 2018

Last updated

Sep 14, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Joanna Ayala

Title

Owner

Phone

(210) 632-4560

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1527724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694649600000",
    "number": "1346732807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 356",
            "city": "LYTLE",
            "state": "TX",
            "postal_code": "780520356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3738 CIBOLO VALLEY DR.",
            "city": "CIBOLO",
            "state": "TX",
            "postal_code": "78108",
            "telephone_number": "830-772-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CIBOLO PEDIATRIC DENTISTRY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-31",
        "last_updated": "2023-09-14",
        "certification_date": "2023-09-14",
        "status": "A",
        "authorized_official_last_name": "AYALA",
        "authorized_official_first_name": "JOANNA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "210-632-4560"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Cibolo Modern Dentistry, PC
• Cibolo-South Texas Center for Pediatric Care
• Coastal ER IX, LLC (Physicians PremiER)
• Yolanda Lynn Cockfield, SPEECH THERAPIST
• Julia Marie Conn, BCBA, LBA
• Counseling Inspirations PLLC

• Oral and Maxillofacial Surgery (Dentist) in Cibolo, TX
• Providers in Cibolo, TX by specialty
• Oral and Maxillofacial Surgery (Dentist) in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 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.