Fredricksburg Smiles PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

FREDRICKSBURG SMILES PLLC

Doing business as

Shine Dental

Practice address

1703 Fredericksburg Road
San Antonio, TX 78210

Phone

(903) 360-8657

NPI assigned

Oct 13, 2021

Last updated

Oct 13, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dhaval Thakkar

Title

Owner / Dentist

Phone

(903) 360-8657

Specialties & licenses 1

Addresses

Other names 1

• Shine Dental Doing business as

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1634083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634083200000",
    "number": "1790447118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6510 APSLEY CREEK LN",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774794371",
            "telephone_number": "903-360-8657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1703 FREDERICKSBURG ROAD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78210",
            "telephone_number": "903-360-8657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREDRICKSBURG SMILES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-13",
        "last_updated": "2021-10-13",
        "certification_date": "2021-09-28",
        "status": "A",
        "authorized_official_last_name": "THAKKAR",
        "authorized_official_first_name": "DHAVAL",
        "authorized_official_title_or_position": "OWNER / DENTIST",
        "authorized_official_telephone_number": "903-360-8657"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "dthakkar@3cdentalgroup.com",
            "affiliation": "N",
            "address_1": "1703 Fredericksburg Road",
            "city": "San antonio",
            "state": "TX",
            "country_code": "US",
            "postal_code": "78210",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Shine Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Melanie C. Frederick, MD
• Fredericksburg Family Dental Care, PLLC
• Fredericksburg Square Dental, PLLC
• Frederico Gonzales Jr (Ayuda Case Management)
• Megan Marie Fredrick, LPC
• Mark Fredrickson, MD
• Freedom Health Services Inc.
• Freedom of Speechies, PLLC. (Speech-ish)
• Freedom Restoration Counseling PLLC
• Freehand Solutions LLC (Health Source America's Chiropractor)

• 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 Oct 13, 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.