NPIMap

Organization Active NPI

Texas Dental Specialist Practice, PLLC

Doing business as Texas Dental Specialists

  • General Practice Dentistry
  • San Antonio, TX
National Provider Identifier
1770225658
Registry record updated Jul 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
TEXAS DENTAL SPECIALIST PRACTICE, PLLC
Doing business as
Texas Dental Specialists
Practice address
1202 W Bitters Rd BLDG 6
San Antonio, TX 78216-7852
Phone
(210) 491-0015
NPI assigned
Apr 11, 2022
Last updated
Jul 26, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
TEXAS DENTAL SPECIALIST PRACTICE, PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 26, 2022

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

Authorized official

Name
Gregory Kostelac
Title
Data Analyst
Phone
(719) 372-5605

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

1202 W Bitters Rd BLDG 6
San Antonio, TX 78216-7852

Mailing address

6110 Barnes Rd
Colorado Springs, CO 80922-2600

Other names 1

  • Texas Dental Specialists Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Texas Dental Specialist Practice PLLC12 organizations share this tax ID, including this one
Part of
Texas Dental Specialist Practice PLLC

Other organizations with this tax ID 11

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

Locations

1202 W Bitters Rd
Bldg 6
San Antonio, TX 78216
Phone (210) 366-3603

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1649635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658793600000",
    "number": "1770225658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6110 BARNES RD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809222600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1202 W BITTERS RD BLDG 6",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782167852",
            "telephone_number": "210-491-0015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEXAS DENTAL SPECIALIST PRACTICE, PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TEXAS DENTAL SPECIALIST PRACTICE, PLLC",
        "enumeration_date": "2022-04-11",
        "last_updated": "2022-07-26",
        "certification_date": "2022-07-26",
        "status": "A",
        "authorized_official_last_name": "KOSTELAC",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_title_or_position": "DATA ANALYST",
        "authorized_official_telephone_number": "719-372-5605"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Texas Dental Specialists",
            "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 Jul 26, 2022; 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.