Smiles of Ingram Park PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

SMILES OF INGRAM PARK PLLC

Doing business as

Premier South Dental Center

Practice address

6722 S Flores St Ste 2
San Antonio, TX 78221-1653

Phone

(210) 922-2166

NPI assigned

Dec 15, 2023

Last updated

Dec 15, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Shraddha Kewalramani, DMDNPI 1487103321

Title

Managing Partner

Phone

(857) 222-1720

Specialties & licenses 1

Addresses

Other names 1

• Premier South Dental Center Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Shraddha Kewalramani

  • General Practice Dentistry
  • San Antonio, TX
  • NPI 1487103321
  NPD Authorized official
• Leslie Smith, DDS

  • Dentist
  • Gonzales, TX
  • NPI 1962056200
  NPD (past)

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

{
    "created_epoch": "1702598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702598400000",
    "number": "1538937867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12206 UPTON PARK",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782534437",
            "telephone_number": "857-222-1720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6722 S FLORES ST STE 2",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782211653",
            "telephone_number": "210-922-2166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMILES OF INGRAM PARK PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-15",
        "last_updated": "2023-12-15",
        "certification_date": "2023-12-15",
        "status": "A",
        "authorized_official_last_name": "KEWALRAMANI",
        "authorized_official_first_name": "SHRADDHA",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "857-222-1720",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Premier South Dental Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Smile Workshop Alamo Ranch, PLLC (Ideal Dental Culebra Alamo Ranch)
• Smile Workshop San Antonio, PLLC (Ideal Dental Westover Hills)
• Smileeasy Dental San Antonio, PLLC
• Smilegivers Professional Corporation
• Smileland Family Dental
• Smiletrends
• Smilewell
• Smilewell
• Karyn Smiley, LMFT
• Stephen Smiley

• General Practice Dentistry in San Antonio, TX
• Providers in San Antonio, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2023; 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.