Kids Smile, PC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

18580 Issued in TX

Legal business name

KIDS SMILE, PC

Practice address

315 N San Saba
Suite #1220
San Antonio, TX 78207-3154

Phone

(210) 225-8888

Fax

(210) 225-4195

NPI assigned

Jun 20, 2008

Organization subpart

No

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

Authorized official

Name

Mauricio Marcushamer, DDSNPI 1699842690

Title

Owner

Phone

(210) 225-8888

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mauricio Marcushamer, DDS

  • Pediatric Dentistry
  • San Antonio, TX
  • NPI 1699842690
  NPD Authorized official

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

{
    "created_epoch": "1213920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213920000000",
    "number": "1871754978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 N SAN SABA",
            "address_2": "SUITE#1220",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782073154",
            "telephone_number": "210-225-8888",
            "fax_number": "210-225-4195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 N SAN SABA",
            "address_2": "SUITE #1220",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782073154",
            "telephone_number": "210-225-8888",
            "fax_number": "210-225-4195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDS SMILE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-20",
        "last_updated": "2008-06-20",
        "status": "A",
        "authorized_official_last_name": "MARCUSHAMER",
        "authorized_official_first_name": "MAURICIO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "210-225-8888",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TX",
            "license": "18580",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1209389-02",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kidney and Primary Care of Texas LLC
• Kidney and Wellness Center PLLC
• Kidney Treatment Center East P a
• Kidney Treatment Center Northwest P a
• Kidney Treatment Center San Antonio Inc
• Kids Teeth, PLLC
• Kids World Pediatric Dentistry
• Kidsteps Pediatric Therapy Center, P. C.
• Courtney Smith Kidwell, P.T.
• Marney B Kidwell, R.N., WHNP

• Pediatric Dentistry in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Pediatric Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 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.