Sister Creek Dental PLLC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

31728 Issued in TX

Legal business name

SISTER CREEK DENTAL PLLC

Practice address

1605 US Highway 181S
Floresville, TX 78114

Phone

(830) 391-8200

Fax

(830) 391-8201

NPI assigned

Sep 7, 2016

Last updated

Sep 7, 2016By 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

Amanda Adamitz

Title

Office Manager

Phone

(830) 391-8200

Specialties & licenses 2

Addresses

Tax ID family

Lost Creek Dental2 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.

• Lost Creek Dental

  • General Practice Dentistry
  • San Antonio, TX
  • NPI 1265829188
  NPD tax ID

Locations

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

{
    "created_epoch": "1473206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473206400000",
    "number": "1821545989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1605 S. HWY 181",
            "city": "FLORESVILLE",
            "state": "TX",
            "postal_code": "78114",
            "telephone_number": "830-391-8200",
            "fax_number": "830-391-8201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1605 US HIGHWAY 181S",
            "city": "FLORESVILLE",
            "state": "TX",
            "postal_code": "78114",
            "telephone_number": "830-391-8200",
            "fax_number": "830-391-8201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SISTER CREEK DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-07",
        "last_updated": "2016-09-07",
        "status": "A",
        "authorized_official_last_name": "ADAMITZ",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "830-391-8200"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TX",
            "license": "29845",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "31728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexandrea Sellers
• Craig E Sessions, MD
• Mary Ann Sieracki, LPC
• Jovita B Silva, RN
• Kristy Ann Silva, M.A., CCC-SLP
• Emily C Skinner, OTR, MOT, CLT
• Michael D Snyder, M. D.
• Caitlin Audrey Soto, RBT
• Hilda Aguado Soto, OT
• South Texas Orthopaedic & Sports Medicine, PA

• Oral and Maxillofacial Surgery (Dentist) in Floresville, TX
• Providers in Floresville, TX by specialty
• Oral and Maxillofacial Surgery (Dentist) in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2016; 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.