Active NPI
Olivia Claire Bustos, DDS
- Dentist
- San Antonio, TX
National Provider Identifier
1477809861
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 28255
- Practice address
- 5983 Bandera Rd
San Antonio, TX 78238-1822 - Phone
- (214) 226-2732
- NPI assigned
- Aug 3, 2012
- Last updated
- Oct 13, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 28255 | TX | Primary |
Addresses
Primary practice location
5983 Bandera Rd
San Antonio, TX 78238-1822
Mailing address
5983 Bandera Rd
San Antonio, TX 78238-1822
Phone (214) 226-2732
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
| License | State | Type | Specialty |
|---|---|---|---|
| 28255 | TX | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1343952000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1413158400000",
"number": "1477809861",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5983 BANDERA RD",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782381822",
"telephone_number": "214-226-2732"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5983 BANDERA RD",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782381822",
"telephone_number": "214-226-2732"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUSTOS",
"first_name": "OLIVIA",
"middle_name": "CLAIRE",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-08-03",
"last_updated": "2014-10-13",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "28255",
"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 Oct 13, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.