Individual provider Active NPI

Vanessa Twining Davenport, DDS

  • Dentist
  • San Antonio, TX
National Provider Identifier
1548607724
Registry record updated Nov 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
28881 Issued in TX
Practice address
5250 Blanco Rd
San Antonio, TX 78216-7017
Phone
(210) 349-3368
NPI assigned
May 29, 2013
Last updated
Nov 14, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 28881 TX Primary

Addresses

Primary practice location

5250 Blanco Rd
San Antonio, TX 78216-7017

Mailing address

403 Allendale Oak
San Antonio, TX 78249-1533
Phone (956) 244-2787

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201223001685 TX Practitioner - Dentist 0042569857

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
28881TXMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Gateway Community Health Center, Inc Current Accepting new patients
Gateway Community Health Center, Inc CurrentSince Sep 19, 2020 Accepting new patients
Gateway Community Health Center Inc CurrentSince Sep 19, 2020 Accepting new patients
Campos Family Dental, P. C. Past Accepting new patients

Locations

1515 Pappas St
Laredo, TX 78041
Phone (956) 523-3642

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1369785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573689600000",
    "number": "1548607724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 ALLENDALE OAK",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782491533",
            "telephone_number": "956-244-2787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5250 BLANCO RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782167017",
            "telephone_number": "210-349-3368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVENPORT",
        "first_name": "VANESSA",
        "middle_name": "TWINING",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-29",
        "last_updated": "2019-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "28881",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.