NPIMap

Organization Active NPI

Northeast Children's Dentistry, Inc

Doing business as Northeast Children's Dentistry-Downtown Location

  • Pediatric Dentistry
  • San Antonio, TX
National Provider Identifier
1356997126
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
NORTHEAST CHILDREN'S DENTISTRY, INC
Doing business as
Northeast Children's Dentistry-Downtown Location
Practice address
315 N San Saba Ste 202
San Antonio, TX 78207-3193
Phone
(210) 223-3383
Fax
(210) 223-1055
NPI assigned
Aug 16, 2019
Last updated
Nov 27, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
NORTHEAST CHILDREN'S DENTISTRY, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Authorized official

Name
Tracey Hay
Title
Practice Coordinator
Phone
(210) 654-6882

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X NU Primary

Addresses

Primary practice location

315 N San Saba Ste 202
San Antonio, TX 78207-3193

Mailing address

315 N San Saba Ste 202
San Antonio, TX 78207-3193
Phone (210) 223-3383

Other identifiers 1

IdentifierTypeStateIssuer
00K78OtherTXBLUE CROSS BLUE SHIELD

Other names 1

  • Northeast Children's Dentistry-Downtown Location Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address DT@necdsa.com Health Information Exchange (HIE)

National Provider Directory

National Provider Directory
Tax ID family
Northeast Children's Dentistry Inc5 organizations share this tax ID, including this one
Part of
Northeast Children's Dentistry Inc

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

315 N San Saba
Ste 202
San Antonio, TX 78207
Phone (210) 223-3383

Interoperability endpoints

  • Direct secure messaging: dt@necdsa.com

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1565913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701043200000",
    "number": "1356997126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 N SAN SABA STE 202",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782073193",
            "telephone_number": "210-223-3383",
            "fax_number": "210-223-1055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 N SAN SABA STE 202",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782073193",
            "telephone_number": "210-223-3383",
            "fax_number": "210-223-1055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST CHILDREN'S DENTISTRY, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTHEAST CHILDREN'S DENTISTRY, INC",
        "enumeration_date": "2019-08-16",
        "last_updated": "2023-11-27",
        "status": "A",
        "authorized_official_last_name": "HAY",
        "authorized_official_first_name": "TRACEY",
        "authorized_official_title_or_position": "PRACTICE COORDINATOR",
        "authorized_official_telephone_number": "210-654-6882"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "00K78",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "DT@necdsa.com",
            "affiliation": "Y",
            "endpointDescription": "Dedicated Office Email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Email",
            "address_1": "315 N San Saba Ste 202",
            "city": "San Antonio",
            "state": "TX",
            "country_code": "US",
            "postal_code": "782073193",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Northeast Children's Dentistry-Downtown Location",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Nov 27, 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.