Southside Childrensa Dental Center

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

27696 Issued in CA

Legal business name

SOUTHSIDE CHILDRENSA DENTAL CENTER

Practice address

125 SW Military Dr
San Antonio, TX 78221-1650

Phone

(210) 922-3483

NPI assigned

Nov 4, 2013

Organization subpart

No

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

Authorized official

Name

Mrs. Doris Zercher

Title

Office Manager

Phone

(210) 922-3483

Specialties & licenses 4

Addresses

Other identifiers 5

Tax ID family

Southside Children'S Dental Center PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Southside Children'S Dental Center, P.C.

  • Pediatric Dentistry
  • San Antonio, TX
  • NPI 1902815335
  NPD tax ID

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

{
    "created_epoch": "1383523200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383523200000",
    "number": "1396174900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 SW MILITARY DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782211650",
            "telephone_number": "210-922-3483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 SW MILITARY DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782211650",
            "telephone_number": "210-922-3483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHSIDE CHILDRENSA DENTAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-04",
        "last_updated": "2013-11-04",
        "status": "A",
        "authorized_official_last_name": "ZERCHER",
        "authorized_official_first_name": "DORIS",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "210-922-3483",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TX",
            "license": "14060",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "WI",
            "license": "23705",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "PA",
            "license": "25239",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "27696",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009833701",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "209944201",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "204974401",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2882862",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "126722102",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Southern Texas Physicians,LLC
• Southern Urgent Care Center L.P
• Southern Urgent Care Center L.P
• Southlake BNPT Investment LLC
• Southside Children'S Dental Center, P.C.
• Southside Family Dental Center PC
• Southside Independent School District
• Southside Isd
• Southside Neurology, PA
• Southside Orthodontic Center PC

• Orthodontics and Dentofacial Orthopedics Dentistry in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2013; 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.