Premier Boerne Dental, PLLC

Primary specialty

DentistTaxonomy code 122300000X

License

22462 Issued in TX

Legal business name

PREMIER BOERNE DENTAL, PLLC

Doing business as

Premier Dental Boerne

Practice address

804 N Main St
Boerne, TX 78006-1626

Phone

(830) 249-8407

NPI assigned

Apr 26, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Luigi Massa, D.D.S.

Title

Owner

Phone

(830) 660-1669

Specialties & licenses 1

Addresses

Other names 1

• Premier Dental Boerne Doing business as

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

{
    "created_epoch": "1461628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461628800000",
    "number": "1699120808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 N MAIN ST",
            "city": "BOERNE",
            "state": "TX",
            "postal_code": "780061626",
            "telephone_number": "830-249-8407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 N MAIN ST",
            "city": "BOERNE",
            "state": "TX",
            "postal_code": "780061626",
            "telephone_number": "830-249-8407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER BOERNE DENTAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-26",
        "last_updated": "2016-04-26",
        "status": "A",
        "authorized_official_last_name": "MASSA",
        "authorized_official_first_name": "LUIGI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "830-660-1669",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "TX",
            "license": "22462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Premier Dental Boerne",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Gerardo Ponce
• Mitchell W Ponsford, DMD
• Autumn Postell, PA
• Sue A Potter
• Kiley M Pradon, DPT
• Premier Physical Therapy & Wellness, LLC
• Premium Pharma, LLC (The Pharmacy at Bergheim)
• Preslar Senior Care LLC (Home Instead Franchise 577)
• Prestige Worldwide Pharma LLC (Hill Country Specialty Pharmacy)
• Paul James Prieto

• Dentist in Boerne, TX
• Providers in Boerne, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2016; 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.