Siva Sethuraman, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

28404 Issued in TX

Practice address

2810 Dacy LN
Kyle, TX 78640-6322

Phone

(512) 268-8900

Fax

(512) 268-2250

NPI assigned

Mar 6, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

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

Practice roles

Locations

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.

• Barrio Comprehensive Family Health Care Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • San Antonio, TX
  • NPI 1902883739
  Medicare reassignment NPD
• Barrio Comprehensive Family Health Care Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • San Marcos, TX
  • NPI 1295601052
  NPD
• Barrio Comprehensive Family Health Care Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • San Antonio, TX
  • NPI 1427357458
  NPD

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

{
    "created_epoch": "1236297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714003200000",
    "number": "1770723595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3066 E COMMERCE ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782201013",
            "telephone_number": "210-233-7000",
            "fax_number": "210-277-6387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2810 DACY LN",
            "city": "KYLE",
            "state": "TX",
            "postal_code": "786406322",
            "telephone_number": "512-268-8900",
            "fax_number": "512-268-2250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SETHURAMAN",
        "first_name": "SIVA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-03-06",
        "last_updated": "2024-04-25",
        "certification_date": "2024-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "28404",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "314500501",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary E Schuwerk, PA-C
• Sally A Schwartz
• Jillian Schwenden
• Nia Marie Segura
• Sandra Serrano, SLP
• Seton Family of Doctors
• Seton Family of Doctors
• Seton Family of Hospitals
• Seton River Bend Home Health, LLC
• Vanessa Severy

• General Practice Dentistry in Kyle, TX
• Providers in Kyle, 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 Apr 25, 2024; 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.