NPIMap

Organization Active NPI

Crownridge Dental

  • Oral and Maxillofacial Surgery Clinic/Center
  • San Antonio, TX
National Provider Identifier
1962028142
Registry record updated Jun 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery Clinic/CenterTaxonomy code 261QS0112X
Legal business name
CROWNRIDGE DENTAL
Practice address
6827 Camp Bullis Rd Ste 302
San Antonio, TX 78256-1730
Phone
(210) 538-7500
Fax
(210) 569-7750
NPI assigned
Jun 23, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2020

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

Authorized official

Name
Christian Alexander PhamNPI 1427060920
Title
Owner
Phone
(210) 538-7500

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
Oral and Maxillofacial Surgery Clinic/Center 261QS0112X Primary

Addresses

Primary practice location

6827 Camp Bullis Rd Ste 302
San Antonio, TX 78256-1730

Mailing address

6827 Camp Bullis Rd Ste 302
San Antonio, TX 78256-1730

National Provider Directory

National Provider Directory

Locations

6827 Camp Bullis Rd
Ste 302
San Antonio, TX 78256
Phone (210) 538-7500

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1592870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592870400000",
    "number": "1962028142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6827 CAMP BULLIS RD STE 302",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782561730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6827 CAMP BULLIS RD STE 302",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782561730",
            "telephone_number": "210-538-7500",
            "fax_number": "210-569-7750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROWNRIDGE DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-23",
        "last_updated": "2020-06-23",
        "certification_date": "2020-06-23",
        "status": "A",
        "authorized_official_last_name": "PHAM",
        "authorized_official_first_name": "CHRISTIAN",
        "authorized_official_middle_name": "ALEXANDER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "210-538-7500"
    },
    "taxonomies": [
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "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 Jun 23, 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.