Full Smile Westover Hills Pediatric Dentistry, PLLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

FULL SMILE WESTOVER HILLS PEDIATRIC DENTISTRY, PLLC

Practice address

9514 Potranco Rd
San Antonio, TX 78251-9601

Phone

(210) 680-8080

Fax

(210) 680-3140

NPI assigned

Oct 31, 2023

Organization subpart

No

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

Authorized official

Name

Jennifer Williams

Title

Credentialing Manager

Phone

(806) 353-1055

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1698710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698710400000",
    "number": "1972376143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9514 POTRANCO RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782519601",
            "telephone_number": "210-680-8080",
            "fax_number": "210-680-3140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9514 POTRANCO RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782519601",
            "telephone_number": "210-680-8080",
            "fax_number": "210-680-3140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FULL SMILE WESTOVER HILLS PEDIATRIC DENTISTRY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-31",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-31",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "806-353-1055"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatric Dentistry in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Pediatric Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 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.