Dental Republic - Bandera, PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

20960 Issued in TX

Legal business name

DENTAL REPUBLIC - BANDERA, PC

Practice address

5720 Bandera Rd
Suite 22
San Antonio, TX 78238-1985

Phone

(210) 888-8308

Fax

(210) 888-8309

NPI assigned

Oct 1, 2015

Organization subpart

No

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

Authorized official

Name

Son Nam Tran, DDS

Title

Dentist/President

Phone

(214) 960-3535

Specialties & licenses 1

Addresses

Other names 1

• Dental Republic Doing business as

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

{
    "created_epoch": "1443657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1443657600000",
    "number": "1447620554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2515 MCKINNEY AVE",
            "address_2": "SUITE 940",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752011908",
            "telephone_number": "214-747-1400",
            "fax_number": "214-242-4455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5720 BANDERA RD",
            "address_2": "SUITE 22",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782381985",
            "telephone_number": "210-888-8308",
            "fax_number": "210-888-8309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL REPUBLIC - BANDERA, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-01",
        "last_updated": "2015-10-01",
        "status": "A",
        "authorized_official_last_name": "TRAN",
        "authorized_official_first_name": "SON",
        "authorized_official_middle_name": "NAM",
        "authorized_official_title_or_position": "DENTIST/PRESIDENT",
        "authorized_official_telephone_number": "214-960-3535",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "20960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dental Republic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Providers in San Antonio, TX by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 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.