RSVM Jackson PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

RSVM JACKSON PLLC

Doing business as

The Dental Space

Practice address

1101 Thorpe LN Ste 101
San Marcos, TX 78666-7139

Phone

(214) 493-1216

Fax

(214) 292-8661

NPI assigned

Jun 3, 2020

Last updated

Jun 3, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Nina Abtahi

Title

Manger

Phone

(214) 493-1216

Specialties & licenses 1

Addresses

Other names 1

• The Dental Space Doing business as

Locations

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

{
    "created_epoch": "1591142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591142400000",
    "number": "1720602923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 THORPE LN STE 101",
            "city": "SAN MARCOS",
            "state": "TX",
            "postal_code": "786667139",
            "telephone_number": "214-493-1216",
            "fax_number": "214-292-8661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 THORPE LN STE 101",
            "city": "SAN MARCOS",
            "state": "TX",
            "postal_code": "786667139",
            "telephone_number": "214-493-1216",
            "fax_number": "214-292-8661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RSVM JACKSON PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-03",
        "last_updated": "2020-06-03",
        "certification_date": "2020-06-03",
        "status": "A",
        "authorized_official_last_name": "ABTAHI",
        "authorized_official_first_name": "NINA",
        "authorized_official_title_or_position": "MANGER",
        "authorized_official_telephone_number": "214-493-1216"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Dental Space",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ayla Roper, LCSW
• Clay Whitten Ross, MD
• Collette N/a Rowe, LVN
• Allison Leigh Royal
• Kayla Rozelle
• Annali Marie Rubio
• Roberto Ruiz Jr., CSA
• John B Rust, M.D.
• RX Management Consultants (The Pharmacy)
• RX Management Consultants Inc (The Pharmacy)

• General Practice Dentistry in San Marcos, TX
• Providers in San Marcos, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2020; 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.