Mysa Dental PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

MYSA DENTAL PLLC

Doing business as

Mysa Dental

Practice address

13762 Potranco Rd Ste 105
San Antonio, TX 78253-4047

Phone

(210) 564-9044

Fax

(210) 564-9088

NPI assigned

Oct 30, 2020

Organization subpart

Yes

Parent organization

MYSA DENTAL PLLCAs reported in NPPES

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

Authorized official

Name

Dr. Khushbu Malhotra, DMDNPI 1114401304

Title

Dentist

Phone

(617) 834-4646

Specialties & licenses 1

Addresses

Other names 1

• Mysa Dental Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Part of

Mysa Dental PLLC

Locations

Practitioners 2

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

• Khushbu Malhotra

  • Dentist
  • San Antonio, TX
  • NPI 1114401304
  NPD Authorized official
• Angelo Cacciatore, DMD

  • Pediatric Dentistry
  • Corona, CA
  • NPI 1043983174
  NPD (past)

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

{
    "created_epoch": "1604016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684108800000",
    "number": "1710587431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10615 YSAMY WAY",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782131659",
            "telephone_number": "617-834-4646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13762 POTRANCO RD STE 105",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782534047",
            "telephone_number": "210-564-9044",
            "fax_number": "210-564-9088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MYSA DENTAL PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MYSA DENTAL PLLC",
        "enumeration_date": "2020-10-30",
        "last_updated": "2023-05-15",
        "certification_date": "2023-05-15",
        "status": "A",
        "authorized_official_last_name": "MALHOTRA",
        "authorized_official_first_name": "KHUSHBU",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "617-834-4646",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mysa Dental",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mysa Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mypsych Mental Health, PLLC
• Mypt
• Amanda Kate Myres, M.D.
• Tiffany Myrick-Brown, RBT
• Sharie Monique Myrick, PHARM.D.
• Nishad Mysore, DO
• Mystic Park SCC LLC (Mystic Park Nursing & Rehab Center)
• Mywtlosssurgeon Associates
• N H Shannon MD PA
• N.P. Consultants VIII, LLC (Rite Away Pharmacy #5)

• Dental Clinic/Center in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Dental Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.