NPIMap

Organization Active NPI

Nannis Little Smiles Dentistry for Children PA

  • Pediatric Dentistry
  • Boerne, TX
National Provider Identifier
1801970579
Registry record updated Jan 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
18733 Issued in TX
Legal business name
NANNIS LITTLE SMILES DENTISTRY FOR CHILDREN PA
Practice address
415 S School St
Boerne, TX 78006
Phone
(830) 249-9888
Fax
(830) 249-7919
NPI assigned
Oct 25, 2006
Last updated
Jan 16, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2008

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

Authorized official

Name
Dr. Nanni Baker, DDS
Title
Owner
Phone
(830) 249-9888

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X 18733 TX Primary

Addresses

Primary practice location

415 S School St
Boerne, TX 78006

Mailing address

415 S School St
Boerne, TX 78006
Phone (830) 249-9888

Other identifiers 2

IdentifierTypeStateIssuer
17556MedicaidNM
90721401MedicaidTX

National Provider Directory

National Provider Directory
Tax ID family
Children's Dental Depot PA2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

NPI Registry JSON

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200441600000",
    "number": "1801970579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 S SCHOOL ST",
            "city": "BOERNE",
            "state": "TX",
            "postal_code": "78006",
            "telephone_number": "830-249-9888",
            "fax_number": "830-249-7919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 S SCHOOL ST",
            "city": "BOERNE",
            "state": "TX",
            "postal_code": "78006",
            "telephone_number": "830-249-9888",
            "fax_number": "830-249-7919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NANNIS LITTLE SMILES DENTISTRY FOR CHILDREN PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2008-01-16",
        "status": "A",
        "authorized_official_last_name": "BAKER",
        "authorized_official_first_name": "NANNI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "830-249-9888",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TX",
            "license": "18733",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "17556",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "90721401",
            "state": "TX"
        }
    ],
    "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 16, 2008; 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.