Advanced Smile Care for Kids, PLLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

ADVANCED SMILE CARE FOR KIDS, PLLC

Practice address

3829 Lockhill Selma Rd
Suite 101
San Antonio, TX 78230-1761

Phone

(210) 366-3606

Fax

(210) 332-9715

NPI assigned

Apr 8, 2016

Organization subpart

No

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

Authorized official

Name

Mr. Jos Selig

Title

Business Manager

Phone

(210) 366-3606

Specialties & licenses 1

Addresses

Other names 1

• Scuba Smiles For Kids Doing business as

Locations

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

{
    "created_epoch": "1460073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1460073600000",
    "number": "1487018271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3829 LOCKHILL SELMA RD",
            "address_2": "SUITE 101",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782301761",
            "telephone_number": "210-366-3606",
            "fax_number": "210-332-9715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3829 LOCKHILL SELMA RD",
            "address_2": "SUITE 101",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782301761",
            "telephone_number": "210-366-3606",
            "fax_number": "210-332-9715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED SMILE CARE FOR KIDS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-08",
        "last_updated": "2016-04-08",
        "status": "A",
        "authorized_official_last_name": "SELIG",
        "authorized_official_first_name": "JOS",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "210-366-3606",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Scuba Smiles For Kids",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Pediatric Dentistry in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Pediatric Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2016; 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.