Culebra Pediatric Dentistry, PLLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

24255 Issued in TX

Legal business name

CULEBRA PEDIATRIC DENTISTRY, PLLC

Doing business as

Tots to Teens Pediatric Dentistry

Practice address

8839 Culebra Road
Suite #105
San Antonio, TX 78251

Phone

(210) 660-7123

NPI assigned

Sep 29, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Joanna Ayala, D.M.D.

Title

President

Phone

(210) 632-4560

Specialties & licenses 2

Addresses

Other names 1

• Tots to Teens Pediatric Dentistry Doing business as

Locations

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

{
    "created_epoch": "1411948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411948800000",
    "number": "1720481278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 356",
            "city": "LYTLE",
            "state": "TX",
            "postal_code": "780520356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8839 CULEBRA ROAD",
            "address_2": "SUITE #105",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78251",
            "telephone_number": "210-660-7123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CULEBRA PEDIATRIC DENTISTRY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-29",
        "last_updated": "2014-09-29",
        "status": "A",
        "authorized_official_last_name": "AYALA",
        "authorized_official_first_name": "JOANNA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "210-632-4560",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TX",
            "license": "24255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tots to Teens Pediatric Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Culebra Ers Acquisition Partners LLC (Complete Care Culebra)
• Culebra Family Dentistry PLLC
• Culebra Injury & Pain Clinic, LLC
• Culebra Meadows Dental Partners PLLC (Risas Dental and Braces)
• Culebra North Dental Care
• Culebra RX Pharmacy
• Culebra Smiles and Orthodontics, PC (Culebra Smiles and Orthodontics)
• Jonathan Michael Cullen, M.D.
• Cullens Medical Services Clinic
• Kayla Culleton

• Pediatric Dentistry in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Pediatric Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2014; 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.