Mina Botros, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

39190 Issued in TX

Practice address

9234 N Loop 1604 W Ste 121
San Antonio, TX 78249-2984

Phone

(210) 681-1121

NPI assigned

Jul 24, 2018

Last updated

May 3, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Bandera Modern Dentistry, PC

  • Dentist
  • San Antonio, TX
  • NPI 1184981433
  NPD (past)
• Easley Dental Corporation

  dba Sierra Commons Dental Group

  • General Practice Dentistry
  • Palmdale, CA
  • NPI 1669536678
  NPD (past)

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

{
    "created_epoch": "1532390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683072000000",
    "number": "1730666595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25051 W INTERSTATE 10 APT 6108",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782579018",
            "telephone_number": "818-930-0584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9234 N LOOP 1604 W STE 121",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782492984",
            "telephone_number": "210-681-1121"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "755 W Rancho Vista Blvd",
            "address_purpose": "LOCATION",
            "city": "Palmdale",
            "state": "CA",
            "postal_code": "935513735",
            "country_code": "US",
            "telephone_number": "661-265-7800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOTROS",
        "first_name": "MINA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-24",
        "last_updated": "2023-05-03",
        "certification_date": "2023-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "102674",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "39190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Catherine Anne Bothwell, M.S.,CCC-SLP
• Nici Eddy Bothwell, MD
• Ravi Botla, M.D.
• Vijaya Botla, RDN, LD
• Sylvia M. Botros-Brey, MD
• Jonathan E Botrous
• Andrew Bott, DDS
• Nicole Bott, MS, CCC-SLP
• Armando Botti, BCBA
• Annah Grace Bottomley, LMSW

• General Practice Dentistry in San Antonio, TX
• Providers in San Antonio, 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 May 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.