Organization Active NPI

Lost Creek Dental Two, PLLC

  • Dental Clinic/Center
  • San Antonio, TX
National Provider Identifier
1669348272
Registry record updated Oct 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
LOST CREEK DENTAL TWO, PLLC
Practice address
11919 Culebra Rd BLDG 2
San Antonio, TX 78253-2102
Phone
(210) 688-0332
NPI assigned
Oct 13, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2025

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

Authorized official

Name
Justin Tice
Title
Operations Manager
Phone
(925) 852-3326

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

11919 Culebra Rd BLDG 2
San Antonio, TX 78253-2102

Mailing address

11919 Culebra Rd BLDG 2
San Antonio, TX 78253-2102
Phone (210) 688-0332

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1760313600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760313600000",
    "number": "1669348272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11919 CULEBRA RD BLDG 2",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782532102",
            "telephone_number": "210-688-0332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11919 CULEBRA RD BLDG 2",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782532102",
            "telephone_number": "210-688-0332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOST CREEK DENTAL TWO, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-10-13",
        "last_updated": "2025-10-13",
        "certification_date": "2025-10-13",
        "status": "A",
        "authorized_official_last_name": "TICE",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "OPERATIONS MANAGER",
        "authorized_official_telephone_number": "925-852-3326"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "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 Oct 13, 2025; 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.