NPIMap

Organization Active NPI

Ideal Dental of Bulverde PLLC

  • Dentist
  • San Antonio, TX
National Provider Identifier
1366814279
Registry record updated Nov 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
IDEAL DENTAL OF BULVERDE PLLC
Practice address
17910 Bulverde Road
Suite 112
San Antonio, TX 78259-3622
Phone
(210) 494-4200
NPI assigned
Oct 30, 2015
Last updated
Nov 20, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2015

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

Authorized official

Name
Sulman Ahmed, DMD
Title
Ceo
Phone
(972) 361-0600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

17910 Bulverde Road
Suite 112
San Antonio, TX 78259-3622

Mailing address

17910 Bulverde Road
Suite 112
San Antonio, TX 78259-3622
Phone (210) 494-4200

National Provider Directory

National Provider Directory

Locations

17910 Bulverde Rd
Ste 112
San Antonio, TX 78259
Phone (210) 494-4200

Practitioners & affiliated clinicians

Practitioners 4

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": "1446163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447977600000",
    "number": "1366814279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17910 BULVERDE ROAD",
            "address_2": "SUITE 112",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782593622",
            "telephone_number": "210-494-4200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17910 BULVERDE ROAD",
            "address_2": "SUITE 112",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782593622",
            "telephone_number": "210-494-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDEAL DENTAL OF BULVERDE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-30",
        "last_updated": "2015-11-20",
        "status": "A",
        "authorized_official_last_name": "AHMED",
        "authorized_official_first_name": "SULMAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "972-361-0600",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Nov 20, 2015; 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.