Individual provider Active NPI

Krishna Malaviya, DDS

  • Dentist
  • San Antonio, TX
National Provider Identifier
1619422904
Registry record updated Sep 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
32273 Issued in TX
Practice address
22250 Bulverde Rd Ste 109
San Antonio, TX 78261-3081
Phone
(210) 403-2700
NPI assigned
Aug 17, 2016
Last updated
Sep 24, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 32273 TX Primary
General Practice Dentistry 1223G0001X 32273 TX

Addresses

Primary practice location

22250 Bulverde Rd Ste 109
San Antonio, TX 78261-3081

Mailing address

1311 Muleshoe Pass
San Antonio, TX 78258-3443
Phone (248) 990-5478

Other practice location 1

7215 N. Loop 1604 E., #102
Converse, TX 78109
Phone (210) 890-4909

Other practice location 2

14124 Culebra Rd Unit 113
San Antonio, TX 78253-7648
Phone (210) 787-3301

Other practice location 3

23522 Wilderness Oak Ste 107
San Antonio, TX 78258-2409
Phone (210) 757-3199

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
32273TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Evans Family Dentistry, PLLC CurrentSince Jun 27, 2021 Accepting new patients
Autumn Heights Dental PLLC PastSince Apr 23, 2023 Accepting new patients
Culebra Family Dentistry PLLC PastSince Aug 13, 2023 Accepting new patients

Locations

22250 Bulverde Rd
Ste 109
San Antonio, TX 78261
Phone (210) 403-2700

Organizations & group practices 3

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": "1471392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727136000000",
    "number": "1619422904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1311 MULESHOE PASS",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782583443",
            "telephone_number": "248-990-5478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22250 BULVERDE RD STE 109",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782613081",
            "telephone_number": "210-403-2700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7215 N. Loop 1604 E., #102",
            "address_purpose": "LOCATION",
            "city": "Converse",
            "state": "TX",
            "postal_code": "78109",
            "country_code": "US",
            "telephone_number": "210-890-4909",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "14124 Culebra Rd Unit 113",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782537648",
            "country_code": "US",
            "telephone_number": "210-787-3301",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "23522 Wilderness Oak Ste 107",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782582409",
            "country_code": "US",
            "telephone_number": "210-757-3199",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MALAVIYA",
        "first_name": "KRISHNA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-17",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "32273",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "32273",
            "primary": false
        }
    ],
    "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 Sep 24, 2024; 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.