South Park Plaza Dental PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

22951 Issued in TX

Legal business name

SOUTH PARK PLAZA DENTAL PLLC

Practice address

2327 SW Military Dr
Ste.102
San Antonio, TX 78224-1428

Phone

(210) 572-2393

NPI assigned

Nov 20, 2015

Organization subpart

No

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

Authorized official

Name

Andrew Scraver, DDS

Title

Owner

Phone

(210) 572-2393

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1447977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447977600000",
    "number": "1669846119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 240157",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782240157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2327 SW MILITARY DR",
            "address_2": "STE.102",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782241428",
            "telephone_number": "210-572-2393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH PARK PLAZA DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-20",
        "last_updated": "2015-11-20",
        "status": "A",
        "authorized_official_last_name": "SCRAVER",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "210-572-2393",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "22951",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• South Medcare Ambulance Inc.
• South Park Family Dental Care PA
• South San Antonio Family Practice, P.a.
• South San Antonio I.S.D.
• South San Antonio Medical Associates
• South San Antonio TX Caregiving LLC
• South Texas Aesthetic and Reconstructive Surgery PLLC

• 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 Nov 20, 2015; 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.