Full Smile Oral Surgery of Alamo Ranch, PLLC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

FULL SMILE ORAL SURGERY OF ALAMO RANCH, PLLC

Practice address

11919 Culebra Rd Ste 205
San Antonio, TX 78253-2129

Phone

(210) 695-5004

NPI assigned

May 17, 2024

Organization subpart

No

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

Authorized official

Name

Jennifer Williams

Title

Contracting Manager

Phone

(210) 695-5004

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Raymond W Kaercher, D.D.S., M.D.

  • Oral and Maxillofacial Pathology Dentistry
  • Helotes, TX
  • NPI 1336122886
  NPD (past)

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

{
    "created_epoch": "1715904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715904000000",
    "number": "1699524041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11919 CULEBRA RD STE 205",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782532129",
            "telephone_number": "210-695-5004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11919 CULEBRA RD STE 205",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782532129",
            "telephone_number": "210-695-5004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FULL SMILE ORAL SURGERY OF ALAMO RANCH, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-17",
        "last_updated": "2024-05-17",
        "certification_date": "2024-05-17",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "CONTRACTING MANAGER",
        "authorized_official_telephone_number": "210-695-5004"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Full Smile Oakwell Farms Orthodontics, PLLC
• Full Smile Westover Hills Pediatric Dentistry, PLLC
• Fuller-Selle, LLC
• Alisa Scott Fuller, RBT
• Amy M Fuller, PHD
• Catherine Marie Fuller, MS, FNP-C

• Oral and Maxillofacial Surgery (Dentist) in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Oral and Maxillofacial Surgery (Dentist) in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2024; 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.