Individual provider Active NPI

Adriana Lynette Rotter, DDS

  • Pediatric Dentistry
  • San Antonio, TX
National Provider Identifier
1528758588
Registry record updated Aug 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
41945 Issued in TX
Practice address
3520 S New Braunfels Ave Ste 100
San Antonio, TX 78223-1406
Phone
(210) 532-3040
NPI assigned
May 11, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatric Dentistry 1223P0221X 41945 TX Primary

Addresses

Primary practice location

3520 S New Braunfels Ave Ste 100
San Antonio, TX 78223-1406

Mailing address

8210 Floyd Curl Dr # Mc8118
San Antonio, TX 78229-3923
Phone (210) 450-3504

Other practice location 1

8210 Floyd Curl Dr # Mc8118
San Antonio, TX 78229-3923
Phone (210) 450-3504

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
41945TXMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Ut Health Science Center Pediatric Dentistry PastSince May 1, 2023 Accepting new patients
Kiddo Denal PA Pediatric Dentistry PastSince Sep 3, 2025 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1683763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756166400000",
    "number": "1528758588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8210 FLOYD CURL DR # MC8118",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293923",
            "telephone_number": "210-450-3504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3520 S NEW BRAUNFELS AVE STE 100",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782231406",
            "telephone_number": "210-532-3040"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8210 Floyd Curl Dr # Mc8118",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782293923",
            "country_code": "US",
            "telephone_number": "210-450-3504",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROTTER",
        "first_name": "ADRIANA",
        "middle_name": "LYNETTE",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-11",
        "last_updated": "2025-08-26",
        "certification_date": "2025-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TX",
            "license": "41945",
            "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 Aug 26, 2025; 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.