NPIMap

Organization Active NPI

Dental Health Associates of Texas, PC

Doing business as Eventide Family Dentistry

  • General Practice Dentistry
  • San Antonio, TX
National Provider Identifier
1902209398
Registry record updated Sep 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
DENTAL HEALTH ASSOCIATES OF TEXAS, PC
Doing business as
Eventide Family Dentistry
Practice address
937 Eventide Dr
San Antonio, TX 78209-5546
Phone
(210) 824-0430
NPI assigned
Sep 30, 2014
Last updated
Sep 30, 2014By the provider in NPPES
Organization subpart
Yes
Parent organization
DENTAL HEALTH ASSOCIATES OF TEXAS, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 30, 2014

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

Authorized official

Name
Kim Wilson
Title
Cred Supervisor
Phone
(217) 540-5170

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

937 Eventide Dr
San Antonio, TX 78209-5546

Mailing address

937 Eventide Dr
San Antonio, TX 78209-5546
Phone (210) 824-0430

Other names 1

  • Eventide Family Dentistry Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dental Health Associates of Texas PC149 organizations share this tax ID, including this one
Part of
Dental Health Associates of Texas PC

Organizations with this tax ID in the same state 23

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 23

Locations

937 Eventide Dr
San Antonio, TX 78209
Phone (210) 824-0430

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1412035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412035200000",
    "number": "1902209398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "937 EVENTIDE DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782095546",
            "telephone_number": "210-824-0430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "937 EVENTIDE DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782095546",
            "telephone_number": "210-824-0430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL HEALTH ASSOCIATES OF TEXAS, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DENTAL HEALTH ASSOCIATES OF TEXAS, PC",
        "enumeration_date": "2014-09-30",
        "last_updated": "2014-09-30",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "CRED SUPERVISOR",
        "authorized_official_telephone_number": "217-540-5170"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eventide Family 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 Sep 30, 2014; 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.