Susan E Dellaripa, D.M.D.
Individual provider Active NPI Dentist · Lackland, TX
NPI 1437433166 · NPPES record last updated Sep 29, 2011
Key facts
- NPI
- 1437433166
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- N/A (TX)
- Practice address
- 1615 Truemper St
Lackland, TX 78236-5511 - Phone
- (210) 671-9612
- NPI assigned
- Sep 29, 2011
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| N/A | TX | MD | Anatomic Pathology Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | N/A | TX | Yes |
Addresses
Primary practice location
1615 Truemper St
Lackland, TX 78236-5511
Mailing address
6202 Roxbury Dr
Apartment 3310
San Antonio, TX 78238-1382
Phone (215) 327-2884
Other providers in Lackland, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 29, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.