Commerce St Family Dental

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

08923 Issued in TX

Legal business name

COMMERCE ST FAMILY DENTAL

Practice address

2522 W Commerce St
San Antonio, TX 78207

Phone

(210) 225-4867

Fax

(210) 225-5643

NPI assigned

Nov 27, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Alfred Gwinn Bradford Jr., DDSNPI 1114093739

Title

Ceo President Chairman of Board

Phone

(210) 225-4867

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Commerce St Family Dental Center PC Former legal business name

Locations

Practitioners 2

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

• Alfred Gwinn Bradford Jr., DDS

  • Dentist
  • San Antonio, TX
  • NPI 1114093739
  NPD (past) Authorized official
• Paul L. Drexel, D.D.S

  • Dentist
  • San Antonio, TX
  • NPI 1609052034
  NPD (past)

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

{
    "created_epoch": "1164585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193270400000",
    "number": "1649346263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2522 W COMMERCE ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78207",
            "telephone_number": "210-225-4867",
            "fax_number": "210-225-5643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2522 W COMMERCE ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78207",
            "telephone_number": "210-225-4867",
            "fax_number": "210-225-5643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMERCE ST FAMILY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-27",
        "last_updated": "2007-10-25",
        "status": "A",
        "authorized_official_last_name": "BRADFORD",
        "authorized_official_first_name": "ALFRED",
        "authorized_official_middle_name": "GWINN",
        "authorized_official_title_or_position": "CEO PRESIDENT CHAIRMAN OF BOARD",
        "authorized_official_telephone_number": "210-225-4867",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "08923",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "87DO73",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Commerce St Family Dental Center PC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Jan C Commer, DPT, PT
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• Elizabeth Ann Commins
• Commit to Health Counseling Services
• Commitment Home Health Services Inc
• Communicare Health
• Community Alliance for Traffic Safety, Inc.

• General Practice Dentistry in San Antonio, TX
• Providers in San Antonio, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2007; 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.