NPIMap

Organization Active NPI

Texas Dental Specialist Practice, PLLC

  • General Practice Dentistry
  • Colorado Springs, CO
National Provider Identifier
1972276673
Registry record updated Dec 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
TEXAS DENTAL SPECIALIST PRACTICE, PLLC
Practice address
6110 Barnes Rd
Colorado Springs, CO 80922-2600
Phone
(719) 266-2717
NPI assigned
Jul 28, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2021

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

Authorized official

Name
Gregory Kostelac
Title
Credentialing Specialist
Phone
(719) 372-5605

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

6110 Barnes Rd
Colorado Springs, CO 80922-2600

Mailing address

6110 Barnes Rd
Colorado Springs, CO 80922-2600

Other practice location 1

20540 Highway 46 W Ste 100
Spring Branch, TX 78070-6825
Phone (830) 980-8099

Other practice location 2

701 State Park Rd
Lockhart, TX 78644-4934
Phone (512) 398-3429

Other practice location 3

21950 Bulverde Rd Ste 103
San Antonio, TX 78259-2174
Phone (210) 494-8850

Other practice location 4

12521 Nacogdoches Rd Ste 103
San Antonio, TX 78217-2117
Phone (210) 653-3452

Other practice location 5

104 W Cedar St
Seguin, TX 78155-3748
Phone (830) 379-9310

Other practice location 6

804 N Main St
Boerne, TX 78006-1626
Phone (830) 249-8407

Other practice location 7

1621 Pat Booker Rd
Universal City, TX 78148-3432
Phone (210) 654-9094

Other practice location 8

1583 E Common St Ste 205
New Braunfels, TX 78130-3174
Phone (830) 625-2111

National Provider Directory

National Provider Directory
Tax ID family
Texas Dental Specialist Practice PLLC12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

Locations

12521 Nacogdoches Rd
Ste 103
San Antonio, TX 78217
Phone (210) 653-3452

NPI Registry JSON

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

{
    "created_epoch": "1627430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639699200000",
    "number": "1972276673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6110 BARNES RD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809222600",
            "fax_number": "719-213-2311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6110 BARNES RD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809222600",
            "telephone_number": "719-266-2717"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20540 Highway 46 W Ste 100",
            "address_purpose": "LOCATION",
            "city": "Spring Branch",
            "state": "TX",
            "postal_code": "780706825",
            "country_code": "US",
            "telephone_number": "830-980-8099",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "701 State Park Rd",
            "address_purpose": "LOCATION",
            "city": "Lockhart",
            "state": "TX",
            "postal_code": "786444934",
            "country_code": "US",
            "telephone_number": "512-398-3429",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "21950 Bulverde Rd Ste 103",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782592174",
            "country_code": "US",
            "telephone_number": "210-494-8850",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12521 Nacogdoches Rd Ste 103",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782172117",
            "country_code": "US",
            "telephone_number": "210-653-3452",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "104 W Cedar St",
            "address_purpose": "LOCATION",
            "city": "Seguin",
            "state": "TX",
            "postal_code": "781553748",
            "country_code": "US",
            "telephone_number": "830-379-9310",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "804 N Main St",
            "address_purpose": "LOCATION",
            "city": "Boerne",
            "state": "TX",
            "postal_code": "780061626",
            "country_code": "US",
            "telephone_number": "830-249-8407",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1621 Pat Booker Rd",
            "address_purpose": "LOCATION",
            "city": "Universal City",
            "state": "TX",
            "postal_code": "781483432",
            "country_code": "US",
            "telephone_number": "210-654-9094",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1583 E Common St Ste 205",
            "address_purpose": "LOCATION",
            "city": "New Braunfels",
            "state": "TX",
            "postal_code": "781303174",
            "country_code": "US",
            "telephone_number": "830-625-2111",
            "fax_number": "719-213-2311",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TEXAS DENTAL SPECIALIST PRACTICE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-28",
        "last_updated": "2021-12-17",
        "certification_date": "2021-12-17",
        "status": "A",
        "authorized_official_last_name": "KOSTELAC",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "719-372-5605"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2021; 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.