NPIMap

Organization Active NPI

SP Administration

Doing business as Westover Hills Family Dental

  • Dentist
  • San Antonio, TX
National Provider Identifier
1730536392
Registry record updated May 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
17028 Issued in TX
Legal business name
SP ADMINISTRATION
Doing business as
Westover Hills Family Dental
Practice address
11212 State Highway 151
Suite 106 Medical Plaza 1
San Antonio, TX 78251-4498
Phone
(210) 257-0953
Fax
(210) 257-5265
NPI assigned
May 24, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 24, 2016

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

Authorized official

Name
Dr. Shiva Izaddoust, D.D.S.
Title
President
Phone
(210) 927-1400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 17028 TX Primary

Addresses

Primary practice location

11212 State Highway 151
Suite 106 Medical Plaza 1
San Antonio, TX 78251-4498

Mailing address

11212 State Highway 151
Suite 106 Medical Plaza 1
San Antonio, TX 78251-4498
Phone (210) 257-0953

Other names 1

  • Westover Hills Family Dental Doing business as

National Provider Directory

National Provider Directory
Tax ID family
SP Administration3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

11212 State Highway 151
Ste 106
San Antonio, TX 78251
Phone (210) 257-0953

NPI Registry JSON

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

{
    "created_epoch": "1464048000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464048000000",
    "number": "1730536392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11212 STATE HIGHWAY 151",
            "address_2": "SUITE 106 MEDICAL PLAZA 1",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782514498",
            "telephone_number": "210-257-0953",
            "fax_number": "210-257-5265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11212 STATE HIGHWAY 151",
            "address_2": "SUITE 106 MEDICAL PLAZA 1",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782514498",
            "telephone_number": "210-257-0953",
            "fax_number": "210-257-5265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SP ADMINISTRATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-24",
        "last_updated": "2016-05-24",
        "status": "A",
        "authorized_official_last_name": "IZADDOUST",
        "authorized_official_first_name": "SHIVA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "210-927-1400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "TX",
            "license": "17028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Westover Hills Family Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 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.