NPIMap

Organization Active NPI

Northeast Children'S Dentistry, Inc

  • Pediatric Dentistry
  • San Antonio, TX
National Provider Identifier
1689220451
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
NORTHEAST CHILDREN'S DENTISTRY, INC
Practice address
4358 Thousand Oaks Dr
San Antonio, TX 78217-2102
Phone
(210) 656-4300
Fax
(210) 656-4302
NPI assigned
Aug 16, 2019
Organization subpart
Yes
Parent organization
NORTHEAST CHILDREN'S DENTISTRY, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Authorized official

Name
Tracey Hay
Title
Practice Coordinator
Phone
(210) 654-6882

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X Primary

Addresses

Primary practice location

4358 Thousand Oaks Dr
San Antonio, TX 78217-2102

Mailing address

4358 Thousand Oaks Dr
San Antonio, TX 78217-2102
Phone (210) 656-4300

Other identifiers 1

IdentifierTypeStateIssuer
00K78OtherTXBLUE CROSS BLUE SHIELD

Other names 1

  • Northeast Children's Dentistry- Northern Oaks Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Noaks@necdsa.com Health Information Exchange (HIE)

National Provider Directory

National Provider Directory
Tax ID family
Northeast Children'S Dentistry Inc5 organizations share this tax ID, including this one
Part of
Northeast Children'S Dentistry Inc

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

4358 Thousand Oaks Dr
San Antonio, TX 78217
Phone (210) 241-5166

Interoperability endpoints

  • Direct secure messaging: noaks@necdsa.com

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 11

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": "1565913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701043200000",
    "number": "1689220451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4358 THOUSAND OAKS DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782172102",
            "telephone_number": "210-656-4300",
            "fax_number": "210-656-4302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4358 THOUSAND OAKS DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782172102",
            "telephone_number": "210-656-4300",
            "fax_number": "210-656-4302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST CHILDREN'S DENTISTRY, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTHEAST CHILDREN'S DENTISTRY, INC",
        "enumeration_date": "2019-08-16",
        "last_updated": "2023-11-27",
        "status": "A",
        "authorized_official_last_name": "HAY",
        "authorized_official_first_name": "TRACEY",
        "authorized_official_title_or_position": "PRACTICE COORDINATOR",
        "authorized_official_telephone_number": "210-654-6882"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "00K78",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Noaks@necdsa.com",
            "affiliation": "Y",
            "endpointDescription": "Dedicated office email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "8606 Village Dr",
            "address_2": "Ste. B",
            "city": "San Antonio",
            "state": "TX",
            "country_code": "US",
            "postal_code": "782175506",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Northeast Children's Dentistry- Northern Oaks",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Northeast Children's Dentistry- Northern Oaks",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Nov 27, 2023; 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.