Highland Family Dentistry

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

17463 Issued in TX

Legal business name

HIGHLAND FAMILY DENTISTRY

Practice address

3630 SE Military Dr
San Antonio, TX 78223-4050

Phone

(210) 337-6834

NPI assigned

Jun 9, 2008

Last updated

Jun 9, 2008By 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

Dr. Malcolm R. Berg

Title

Dentist

Phone

(210) 337-6834

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Malcolm R. Berg, DMD Other name

Tax ID family

Highland Family Dentistry2 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.

• Malcolm R. Berg, DMD, LLC

  dba Plum Creek Dental Group

  • Dentist
  • Lockhart, TX
  • NPI 1306154166
  NPD tax ID

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

{
    "created_epoch": "1212969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212969600000",
    "number": "1841459310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3601 LEADVILLE DR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787496938",
            "telephone_number": "512-965-0663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3630 SE MILITARY DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782234050",
            "telephone_number": "210-337-6834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HIGHLAND FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-09",
        "last_updated": "2008-06-09",
        "status": "A",
        "authorized_official_last_name": "BERG",
        "authorized_official_first_name": "MALCOLM",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "210-337-6834",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "17463",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "164291001",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0094708-03",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Malcolm R. Berg, DMD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Elizabeth Ann Higham
• Highpointe Global LLC (HighPointe Healthcare Services)
• Aquilla Lynette Highsmith-Tyler, MD
• Mark Weldon Highsmith, PHARM.D.
• Stephanie Denise Highsmith, FNP
• Alec Hight

• 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 Jun 9, 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.