Tatianna Alexis McKissick, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

42045 Issued in TX

Practice address

10103 W Loop 1604 N Ste 104
San Antonio, TX 78254-9716

Phone

(210) 495-2000

NPI assigned

Feb 26, 2024

Last updated

Apr 8, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Braun 7To7 PLLC

  • Dental Clinic/Center
  • San Antonio, TX
  • NPI 1417622432
  NPD (past)
• SC Shine PLLC

  dba Texas Dental

  • General Practice Dentistry
  • San Antonio, TX
  • NPI 1356527949
  NPD (past)

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

{
    "created_epoch": "1708905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775606400000",
    "number": "1841056058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10103 W LOOP 1604 N STE 104",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782549716",
            "telephone_number": "210-495-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10103 W LOOP 1604 N STE 104",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782549716",
            "telephone_number": "210-495-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKISSICK",
        "first_name": "TATIANNA",
        "middle_name": "ALEXIS",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-26",
        "last_updated": "2026-04-08",
        "certification_date": "2026-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "42045",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melanie McKinney
• Mollie McKinney, M.S., CCC-SLP
• Nora Katharine McKinney, DDS
• Tanisha McKinney
• Bennie Marie McKinnon
• Laura Pratt McKnight
• Macey McKnight, M.A., CCC-SLP
• Sean William McKnight, D.C.
• Treva McKnight, CRNA
• Shawn McKown, PSY.D.

• 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 Apr 8, 2026; 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.