Individual provider Active NPI

Devon Fulbright

  • General Practice Dentistry
  • San Antonio, TX
National Provider Identifier
1558893164
Registry record updated Mar 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
33019 Issued in TX
Practice address
3301 Oakwell CT Ste 102
San Antonio, TX 78218-3075
Phone
(210) 832-9993
NPI assigned
Apr 2, 2017
Last updated
Mar 25, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 25, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 33019 TX Primary

Addresses

Primary practice location

3301 Oakwell CT Ste 102
San Antonio, TX 78218-3075

Mailing address

23139 Angostura Blvd
San Antonio, TX 78261-2619
Phone (210) 452-0842

Other practice location 1

15909 San Pedro Ave Ste 200
San Antonio, TX 78232-3743
Phone (210) 494-4011

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
33019TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Gregory a. Osborne DDS PA PastSince Jun 1, 2021 Accepting new patients
Oakwell Dental Care General Practice Past Accepting new patients
My Hometown Dentist at Hollywood Park PLLC PastSince Mar 17, 2024 Accepting new patients
Erin a. McLendon, D.D.S. Past Accepting new patients

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": "1491091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553472000000",
    "number": "1558893164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23139 ANGOSTURA BLVD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782612619",
            "telephone_number": "210-452-0842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3301 OAKWELL CT STE 102",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782183075",
            "telephone_number": "210-832-9993"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15909 San Pedro Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782323743",
            "country_code": "US",
            "telephone_number": "210-494-4011",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FULBRIGHT",
        "first_name": "DEVON",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-02",
        "last_updated": "2019-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "33019",
            "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 Mar 25, 2019; 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.