Organization Active NPI

Northwoods Dental Spa

  • General Practice Dentistry
  • San Antonio, TX
National Provider Identifier
1811077407
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
NORTHWOODS DENTAL SPA
Practice address
18160 Hwy 281 North
Suite 104
San Antonio, TX 78232
Phone
(210) 495-7800
Fax
(210) 495-7805
NPI assigned
Oct 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Irene Kiansky Blaess, DDS
Title
Owner Dentists
Phone
(210) 495-7800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

18160 Hwy 281 North
Suite 104
San Antonio, TX 78232

Mailing address

18160 Hwy 281 N
Ste 104
San Antonio, TX 78232
Phone (210) 495-7800

National Provider Directory

National Provider Directory

Locations

18160 San Pedro Ave
Ste 104
San Antonio, TX 78232
Phone (210) 495-7800

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1811077407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18160 HWY 281 N",
            "address_2": "STE 104",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78232",
            "telephone_number": "210-495-7800",
            "fax_number": "210-495-7805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18160 HWY 281 NORTH",
            "address_2": "SUITE 104",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78232",
            "telephone_number": "210-495-7800",
            "fax_number": "210-495-7805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWOODS DENTAL SPA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BLAESS",
        "authorized_official_first_name": "IRENE",
        "authorized_official_middle_name": "KIANSKY",
        "authorized_official_title_or_position": "OWNER DENTISTS",
        "authorized_official_telephone_number": "210-495-7800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Aug 22, 2020; 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.