Active NPI
Kye Edward Mallernee, D.M.D.
- Dentist
- San Antonio, TX
National Provider Identifier
1679959613
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 31328
- Practice address
- 9820 Braun Rd Ste 102
San Antonio, TX 78254 - Phone
- (210) 523-2400
- NPI assigned
- Jul 31, 2015
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Dentist | 122300000X | 31328 | TX | Primary |
Addresses
Primary practice location
9820 Braun Rd Ste 102
San Antonio, TX 78254
Mailing address
9820 Braun Rd Ste 102
San Antonio, TX 78254-9657
Phone (210) 523-2400
Other practice location 1
9929 S Padre Island Dr
119
Corpus Christi, TX 78418-5105
Phone (361) 937-8333
Other practice location 2
9820 Braun Rd Ste 102
San Antonio, TX 78254
Phone (210) 523-2400
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 |
|---|---|---|---|
| 31328 | TX | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Braun Family Dental | Past | Accepting new patients | |
| Cam Janse D.D.S. P.C | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Practice Dentistry
- San Antonio, TX
- NPI 1043452451
-
- General Practice Dentistry
- San Antonio, TX
- NPI 1164430401
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1438300800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1559520000000",
"number": "1679959613",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9820 BRAUN RD STE 102",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782549657",
"telephone_number": "210-523-2400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9820 BRAUN RD STE 102",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "78254",
"telephone_number": "210-523-2400"
}
],
"practiceLocations": [
{
"address_1": "9929 S Padre Island Dr",
"address_2": "119",
"address_purpose": "LOCATION",
"city": "Corpus Christi",
"state": "TX",
"postal_code": "784185105",
"country_code": "US",
"telephone_number": "361-937-8333",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "9820 Braun Rd Ste 102",
"address_purpose": "LOCATION",
"city": "San Antonio",
"state": "TX",
"postal_code": "78254",
"country_code": "US",
"telephone_number": "210-523-2400",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MALLERNEE",
"first_name": "KYE",
"middle_name": "EDWARD",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-07-31",
"last_updated": "2019-06-03",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "31328",
"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 Jun 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.