Individual provider Active NPI

Grace Jie Zhang, DMD

  • General Practice Dentistry
  • Boerne, TX
National Provider Identifier
1760093397
Registry record updated Jan 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
36264 Issued in TX
Practice address
1677 River Rd Ste 103
Boerne, TX 78006-2483
Phone
(830) 331-5456
NPI assigned
Aug 17, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 36264 TX Primary

Addresses

Primary practice location

1677 River Rd Ste 103
Boerne, TX 78006-2483

Mailing address

7815 Sierra Seco
San Antonio, TX 78240-1969
Phone (210) 882-8013

Other practice location 1

2320 W Loop 340 Ste 200B
Waco, TX 76711-2454
Phone (254) 230-9597

Other practice location 2

11535 West Ave # A
San Antonio, TX 78213-1343
Phone (210) 366-0100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
36264TXMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Dan Alineum Dental-Waco PLLC General Practice CurrentSince Jul 17, 2021 Accepting new patients

Locations

2320 W Loop 340
Ste 200B
Waco, TX 76711
Phone (254) 230-9597

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1597622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609891200000",
    "number": "1760093397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7815 SIERRA SECO",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782401969",
            "telephone_number": "210-882-8013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1677 RIVER RD STE 103",
            "city": "BOERNE",
            "state": "TX",
            "postal_code": "780062483",
            "telephone_number": "830-331-5456"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2320 W Loop 340 Ste 200B",
            "address_purpose": "LOCATION",
            "city": "Waco",
            "state": "TX",
            "postal_code": "767112454",
            "country_code": "US",
            "telephone_number": "254-230-9597",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11535 West Ave # A",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782131343",
            "country_code": "US",
            "telephone_number": "210-366-0100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZHANG",
        "first_name": "GRACE",
        "middle_name": "JIE",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-17",
        "last_updated": "2021-01-06",
        "certification_date": "2021-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "36264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boerne, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2021; 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.