Individual provider Active NPI

Tara Kristin Eisenrich, D.D.S.

  • General Practice Dentistry
  • San Antonio, TX
National Provider Identifier
1437561230
Registry record updated Jan 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
29920 Issued in TX
Practice address
7614 Culebra Rd
Suite 103
San Antonio, TX 78251-1477
Phone
(210) 523-0000
NPI assigned
May 28, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 29920 TX Primary

Addresses

Primary practice location

7614 Culebra Rd
Suite 103
San Antonio, TX 78251-1477

Mailing address

7614 Culebra Rd
Suite 103
San Antonio, TX 78251-1477
Phone (210) 523-0000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
29920TXMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1401235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422576000000",
    "number": "1437561230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7614 CULEBRA RD",
            "address_2": "SUITE 103",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782511477",
            "telephone_number": "210-523-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7614 CULEBRA RD",
            "address_2": "SUITE 103",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782511477",
            "telephone_number": "210-523-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EISENRICH",
        "first_name": "TARA",
        "middle_name": "KRISTIN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-28",
        "last_updated": "2015-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "29920",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jan 30, 2015; 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.