Active NPI
Sayed M. Fazely
- General Practice Dentistry
- San Antonio, TX
National Provider Identifier
1649494121
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 18079
- Practice address
- 6806 W Military Dr
San Antonio, TX 78227-3670 - Phone
- (210) 670-0100
- Fax
- (210) 670-0103
- NPI assigned
- Apr 13, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 18079 | TX | Primary |
Addresses
Primary practice location
6806 W Military Dr
San Antonio, TX 78227-3670
Mailing address
6806 W Military Dr
San Antonio, TX 78227-3670
Phone (210) 670-0100
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 18079 | Other | TX | DENTAL LICENSE NUMBER |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 18079 | TX | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176422400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1649494121",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6806 W MILITARY DR",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782273670",
"telephone_number": "210-670-0100",
"fax_number": "210-670-0103"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6806 W MILITARY DR",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782273670",
"telephone_number": "210-670-0100",
"fax_number": "210-670-0103"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAZELY",
"first_name": "SAYED",
"middle_name": "M.",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-13",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "18079",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DENTAL LICENSE NUMBER",
"identifier": "18079",
"state": "TX"
}
],
"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 Jul 9, 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.