Individual provider Active NPI

Bryan Efrain Soto, D.D.S.

  • General Practice Dentistry
  • San Antonio, TX
National Provider Identifier
1669619078
Registry record updated Apr 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
23972 Issued in TX
Practice address
20210 Stone Oak Pkwy Ste 209
San Antonio, TX 78258-7029
Phone
(210) 787-2062
Fax
(210) 212-3902
NPI assigned
Jan 8, 2009
Last updated
Apr 16, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 23972 TX Primary

Addresses

Primary practice location

20210 Stone Oak Pkwy Ste 209
San Antonio, TX 78258-7029

Mailing address

26002 Destiny RDG
San Antonio, TX 78260-2573
Phone (210) 542-0387

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
23972TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Solorzano and Soto DDS P.L.L.C. CurrentSince Apr 19, 2020 Accepting new patients
Campos Family Dental. P.C, General Practice Past Accepting new patients
Canyon Golf Family Dentistry General Practice PastSince Apr 19, 2020 Accepting new patients

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": "1231372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586995200000",
    "number": "1669619078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26002 DESTINY RDG",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782602573",
            "telephone_number": "210-542-0387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20210 STONE OAK PKWY STE 209",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782587029",
            "telephone_number": "210-787-2062",
            "fax_number": "210-212-3902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOTO",
        "first_name": "BRYAN",
        "middle_name": "EFRAIN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-01-08",
        "last_updated": "2020-04-16",
        "certification_date": "2020-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "23972",
            "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 Apr 16, 2020; 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.