Valudental Walzem1 PLLC

Primary specialty

DentistTaxonomy code 122300000X

License

25764 Issued in TX

Legal business name

VALUDENTAL WALZEM1 PLLC

Practice address

5201 Walzem Rd
Windcrest, TX 78218-2122

Phone

(210) 686-0749

Fax

(281) 533-6130

NPI assigned

Oct 3, 2017

Last updated

Feb 13, 2020By 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

Bradley Michael Smith, DDS

Title

Owner

Phone

(210) 686-0749

Specialties & licenses 1

Addresses

Other names 1

• Celebrate Dental & Braces Walzeml Other name

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

{
    "created_epoch": "1506988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581552000000",
    "number": "1396255469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5201 WALZEM RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78218",
            "telephone_number": "210-686-0749",
            "fax_number": "210-233-8859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5201 WALZEM RD",
            "city": "WINDCREST",
            "state": "TX",
            "postal_code": "782182122",
            "telephone_number": "210-686-0749",
            "fax_number": "281-533-6130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALUDENTAL WALZEM1 PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-03",
        "last_updated": "2020-02-13",
        "certification_date": "2020-02-13",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "210-686-0749",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "25764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Celebrate Dental & Braces Walzeml",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Dentist in Windcrest, TX
• Providers in Windcrest, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2020; 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.