The Institute of Esthetic Dentistry, LLP

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

18102 Issued in TX

Legal business name

THE INSTITUTE OF ESTHETIC DENTISTRY, LLP

Practice address

4455 Medical Drive
Suite a
San Antonio, TX 78229

Phone

(210) 692-0153

Fax

(210) 692-0160

NPI assigned

May 4, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Simona Cuevas, D.D.S.

Title

Dentist

Phone

(210) 692-0153

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1861604753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4455 MEDICAL DRIVE",
            "address_2": "SUITE A",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78229",
            "telephone_number": "210-692-0153",
            "fax_number": "210-692-0160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4455 MEDICAL DRIVE",
            "address_2": "SUITE A",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78229",
            "telephone_number": "210-692-0153",
            "fax_number": "210-692-0160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE INSTITUTE OF ESTHETIC DENTISTRY, LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CUEVAS",
        "authorized_official_first_name": "SIMONA",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "210-692-0153",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "18102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• 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.