Organization Active NPI

Stevens Ranch Modern Dentistry, PC

  • Dentist
  • San Antonio, TX
National Provider Identifier
1891476578
Registry record updated Jul 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
STEVENS RANCH MODERN DENTISTRY, PC
Practice address
14314 Potranco Rd, Ste 109
San Antonio, TX 78245
Phone
(830) 455-4967
Fax
(830) 455-4967
NPI assigned
Jul 26, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2023

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

Authorized official

Name
Maria A Alston, DDS
Title
Owner
Phone
(830) 455-4967

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

14314 Potranco Rd, Ste 109
San Antonio, TX 78245

Mailing address

PO Box 920050
Dallas, TX 75392-0050
Phone (714) 845-8890

Other names 1

  • Stevens Ranch Modern Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

14314 Potranco Rd
Ste 109
San Antonio, TX 78253
Phone (702) 287-6065

NPI Registry JSON

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

{
    "created_epoch": "1690329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690329600000",
    "number": "1891476578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 920050",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753920050",
            "telephone_number": "714-845-8890",
            "fax_number": "303-952-0892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14314 POTRANCO RD, STE 109",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78245",
            "telephone_number": "830-455-4967",
            "fax_number": "830-455-4967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEVENS RANCH MODERN DENTISTRY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-26",
        "last_updated": "2023-07-26",
        "certification_date": "2023-07-24",
        "status": "A",
        "authorized_official_last_name": "ALSTON",
        "authorized_official_first_name": "MARIA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "830-455-4967",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Stevens Ranch Modern Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 26, 2023; 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.