Organization Active NPI

Alamo Heights Periodontics PC

  • Periodontics
  • San Antonio, TX
National Provider Identifier
1407062193
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
20683 Issued in TX
Legal business name
ALAMO HEIGHTS PERIODONTICS PC
Practice address
7231 Broadway St
San Antonio, TX 78209-3701
Phone
(210) 822-7002
Fax
(210) 824-1433
NPI assigned
May 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Monica Alana Flynn, DMDNPI 1093921777
Title
Director
Phone
(210) 822-7002

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PeriodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0300X 20683 TX Primary

Addresses

Primary practice location

7231 Broadway St
San Antonio, TX 78209-3701

Mailing address

7231 Broadway St
San Antonio, TX 78209-3701
Phone (210) 822-7002

Other identifiers 1

IdentifierTypeStateIssuer
1360869OtherUNITED CONCORDIA ID

National Provider Directory

National Provider Directory

Locations

7231 Broadway
San Antonio, TX 78209
Phone (210) 822-7002

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1407062193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7231 BROADWAY ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782093701",
            "telephone_number": "210-822-7002",
            "fax_number": "210-824-1433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7231 BROADWAY ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782093701",
            "telephone_number": "210-822-7002",
            "fax_number": "210-824-1433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALAMO HEIGHTS PERIODONTICS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FLYNN",
        "authorized_official_first_name": "MONICA",
        "authorized_official_middle_name": "ALANA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "210-822-7002",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": "TX",
            "license": "20683",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA ID",
            "identifier": "1360869",
            "state": null
        }
    ],
    "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 Aug 22, 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.