City Base Pediatric Dentistry, PLLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

CITY BASE PEDIATRIC DENTISTRY, PLLC

Practice address

2302 SE Military Dr Ste 101
San Antonio, TX 78223-3586

Phone

(830) 772-5600

NPI assigned

Nov 24, 2020

Last updated

Nov 24, 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

Joanna Ayala, DMDNPI 1730327578

Title

Owner

Phone

(830) 772-5600

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Joanna Cristine Ayala, D.M.D.

  • Pediatric Dentistry
  • Laredo, TX
  • NPI 1730327578
  Authorized official Same address or phone

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

{
    "created_epoch": "1606176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606176000000",
    "number": "1427652932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 356",
            "city": "LYTLE",
            "state": "TX",
            "postal_code": "780520356",
            "telephone_number": "956-725-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2302 SE MILITARY DR STE 101",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782233586",
            "telephone_number": "830-772-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY BASE PEDIATRIC DENTISTRY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-24",
        "last_updated": "2020-11-24",
        "certification_date": "2020-11-24",
        "status": "A",
        "authorized_official_last_name": "AYALA",
        "authorized_official_first_name": "JOANNA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "830-772-5600",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tina Cisneros, LPC
• Veronica Cordero Cisneros
• Whitney Cisneros
• Esmeralda Citron, SLP ASSISTANT
• City Base Ers Acquisition Partners LLC (Brooks City Base Complete Care)
• City Center Health Careers
• City of Alamo Heights (Alamo Heights Fire/EMS)
• City of San Antonio
• City of San Antonio Metropolitan Health District
• City of San Antonio Metropolitan Health District

• Pediatric Dentistry in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Pediatric Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 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.