NPIMap

Organization Active NPI

Pan Am Dental LP

  • Clinic/Center
  • San Antonio, TX
National Provider Identifier
1750409686
Registry record updated Apr 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
20173 Issued in TX
Legal business name
PAN AM DENTAL LP
Practice address
600 Division Ave
Suite a
San Antonio, TX 78214-1350
Phone
(210) 342-2000
Fax
(210) 342-2517
NPI assigned
Mar 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2012

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

Authorized official

Name
Ms. Barbara Mata
Title
Office Manager
Phone
(210) 342-2000

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 20176 TX
Clinic/Center 261Q00000X 20173 TX Primary

Addresses

Primary practice location

600 Division Ave
Suite a
San Antonio, TX 78214-1350

Mailing address

8261 Fredericksburg Rd
San Antonio, TX 78229-3357
Phone (210) 924-7277

Other identifiers 1

IdentifierTypeStateIssuer
155832201MedicaidTX

Other names 1

  • Dental Office Other name

National Provider Directory

National Provider Directory

Locations

600 Division Ave
Ste A
San Antonio, TX 78214
Phone (210) 342-2000

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335312000000",
    "number": "1750409686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8261 FREDERICKSBURG RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293357",
            "telephone_number": "210-924-7277",
            "fax_number": "210-922-5199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 DIVISION AVE",
            "address_2": "SUITE A",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782141350",
            "telephone_number": "210-342-2000",
            "fax_number": "210-342-2517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAN AM DENTAL LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-27",
        "last_updated": "2012-04-25",
        "status": "A",
        "authorized_official_last_name": "MATA",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "210-342-2000",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "TX",
            "license": "20176",
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "TX",
            "license": "20173",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "155832201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dental Office",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Apr 25, 2012; 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.