Organization Active NPI

Bigway Family Dental PLLC

  • General Practice Dentistry
  • San Antonio, TX
National Provider Identifier
1902410699
Registry record updated Nov 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
BIGWAY FAMILY DENTAL PLLC
Practice address
11930 W US Highway 90 Ste 106
San Antonio, TX 78245-9613
Phone
(210) 858-5570
Fax
(210) 858-9494
NPI assigned
Sep 1, 2020
Last updated
Nov 13, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2025

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

Authorized official

Name
Ayodele Oluropo IfarajimiNPI 1982197497
Title
Dentist
Phone
(210) 858-5570

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X Primary

Addresses

Primary practice location

11930 W US Highway 90 Ste 106
San Antonio, TX 78245-9613

Mailing address

11930 W US Highway 90 Ste 106
San Antonio, TX 78245-9613
Phone (210) 858-5570

Other identifiers 1

IdentifierTypeStateIssuer
384599215MedicaidTX

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL OPENDENTAL Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210323000265 TX Part B Supplier - Clinic/Group Practice 7719394592 Receives reassigned benefits from 1 practitioner
Practice locations: San Antonio, TX

National Provider Directory

National Provider Directory

Locations

11930 W US Highway 90
Ste 106
San Antonio, TX 78245
Phone (210) 209-8418

Practitioners & affiliated clinicians

Practitioners 1

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": "1598918400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762992000000",
    "number": "1902410699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11930 W US HIGHWAY 90 STE 106",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782459613",
            "telephone_number": "210-858-5570",
            "fax_number": "210-858-9494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11930 W US HIGHWAY 90 STE 106",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782459613",
            "telephone_number": "210-858-5570",
            "fax_number": "210-858-9494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BIGWAY FAMILY DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-01",
        "last_updated": "2025-11-13",
        "certification_date": "2025-11-13",
        "status": "A",
        "authorized_official_last_name": "IFARAJIMI",
        "authorized_official_first_name": "AYODELE",
        "authorized_official_middle_name": "OLUROPO",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "210-858-5570"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "384599215",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "OPENDENTAL",
            "affiliation": "N",
            "endpointDescription": "OPENDENTAL",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "11930 U.S . Hwy. 90, West",
            "address_2": "Suite 106",
            "city": "San Antonio",
            "state": "TX",
            "country_code": "US",
            "postal_code": "78252",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Nov 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.