Individual provider Active NPI

Sean Cavendish Gardner, DDS

  • Dentist
  • San Antonio, TX
National Provider Identifier
1841925302
Registry record updated Jul 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
38735 Issued in TX
Practice address
3740 Colony Dr Ste 254
San Antonio, TX 78230-2233
Phone
(210) 690-5170
NPI assigned
Jul 19, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 38735 TX Primary

Addresses

Primary practice location

3740 Colony Dr Ste 254
San Antonio, TX 78230-2233

Mailing address

4903 Owl Haven St
San Antonio, TX 78250-4736
Phone (210) 571-3919

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
38735TXMDSpeech-Language Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
James David Oei DDS PA CurrentSince Sep 5, 2023 Accepting new patients

Locations

3740 Colony Dr
Ste 254
San Antonio, TX 78230
Phone (210) 690-5170

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1658188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658188800000",
    "number": "1841925302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4903 OWL HAVEN ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782504736",
            "telephone_number": "210-571-3919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3740 COLONY DR STE 254",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782302233",
            "telephone_number": "210-690-5170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "SEAN",
        "middle_name": "CAVENDISH",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-19",
        "last_updated": "2022-07-19",
        "certification_date": "2022-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "38735",
            "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 Jul 19, 2022; 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.