Five Star Family Dental, PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

FIVE STAR FAMILY DENTAL, PLLC

Practice address

12991 Potranco Rd Ste 107
San Antonio, TX 78253-7105

Phone

(210) 455-1110

NPI assigned

Oct 28, 2020

Last updated

Nov 6, 2020By 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

Dr. Roger Brandon Jr., DDSNPI 1023135704

Title

Owner

Phone

(210) 455-1110

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Roger Brandon, DDS

  • Dentist
  • San Antonio, TX
  • NPI 1023135704
  NPD Authorized official

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

{
    "created_epoch": "1603843200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604620800000",
    "number": "1558961540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12991 POTRANCO RD STE 107",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782537105",
            "telephone_number": "210-455-1110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12991 POTRANCO RD STE 107",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782537105",
            "telephone_number": "210-455-1110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIVE STAR FAMILY DENTAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-28",
        "last_updated": "2020-11-06",
        "certification_date": "2020-11-06",
        "status": "A",
        "authorized_official_last_name": "BRANDON",
        "authorized_official_first_name": "ROGER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "210-455-1110",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jean A Fitzpatrick
• Molly Fitzpatrick, MD
• Pamela Jean Fitzpatrick, PH.D.
• Valaria Fitzpatrick
• Linzy Ann Fitzsimons, M.D.
• Five Star Lincoln Heights, LLC (The Forum at Lincoln Heights)
• Five Star Medical Supplies Trader LLC
• Five Star Medical Supply Incorporated
• Five Star Quality Care-TX, LLC (The Haven & Laurels in Stone Oak)
• Five Star Rehabilitation and Wellness Services, LLC (Ageility Physical Therapy Solutions at Franklin Park Sonterra)

• Dental Clinic/Center in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Dental Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2020; 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.