NPIMap

Organization Active NPI

Texas Dental Specialist Practice, PLLC

Doing business as Texas Dental Specialists

  • General Practice Dentistry
  • Seguin, TX
National Provider Identifier
1477213312
Registry record updated Jul 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
TEXAS DENTAL SPECIALIST PRACTICE, PLLC
Doing business as
Texas Dental Specialists
Practice address
104 W Cedar St
Seguin, TX 78155-3748
Phone
(830) 379-9310
NPI assigned
Dec 20, 2021
Last updated
Jul 26, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
TEXAS DENTAL SPECIALIST PRACTICE, PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 26, 2022

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

Authorized official

Name
Gregory Kostelac
Title
Credentialing Specialist
Phone
(719) 372-5605

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

104 W Cedar St
Seguin, TX 78155-3748

Mailing address

6110 Barnes Rd
Colorado Springs, CO 80922-2600

Other names 1

  • Texas Dental Specialists Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Texas Dental Specialist Practice PLLC12 organizations share this tax ID, including this one
Part of
Texas Dental Specialist Practice PLLC

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1639958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658793600000",
    "number": "1477213312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6110 BARNES RD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809222600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 W CEDAR ST",
            "city": "SEGUIN",
            "state": "TX",
            "postal_code": "781553748",
            "telephone_number": "830-379-9310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEXAS DENTAL SPECIALIST PRACTICE, PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TEXAS DENTAL SPECIALIST PRACTICE, PLLC",
        "enumeration_date": "2021-12-20",
        "last_updated": "2022-07-26",
        "certification_date": "2022-07-26",
        "status": "A",
        "authorized_official_last_name": "KOSTELAC",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "719-372-5605"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Texas Dental Specialists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Seguin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2022; 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.