Organization Active NPI

Kairos Dental Group, PLLC

  • General Practice Dentistry
  • San Antonio, TX
National Provider Identifier
1619835535
Registry record updated Jan 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
KAIROS DENTAL GROUP, PLLC
Practice address
3414 Roosevelt Ave
San Antonio, TX 78214-2606
Phone
(210) 909-5502
NPI assigned
Jan 10, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2026

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

Authorized official

Name
Dr. Joshua Mijares, DDSNPI 1760069157
Title
Owner/Dentist
Phone
(210) 909-5502

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

3414 Roosevelt Ave
San Antonio, TX 78214-2606

Mailing address

4115 Pond Hill Rd Ste 102
Shavano Park, TX 78231-1285
Phone (210) 909-5502

National Provider Directory

National Provider Directory

Locations

4115 Pond Hill Rd
Ste 102
Shavano Park, TX 78231
Phone (210) 788-1967

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1768003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768003200000",
    "number": "1619835535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4115 POND HILL RD STE 102",
            "city": "SHAVANO PARK",
            "state": "TX",
            "postal_code": "782311285",
            "telephone_number": "210-909-5502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3414 ROOSEVELT AVE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782142606",
            "telephone_number": "210-909-5502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAIROS DENTAL GROUP, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-01-10",
        "last_updated": "2026-01-10",
        "certification_date": "2026-01-10",
        "status": "A",
        "authorized_official_last_name": "MIJARES",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "210-909-5502",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "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 Jan 10, 2026; 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.