Active NPI
Dental Dental PLLC
- General Practice Dentistry
- San Antonio, TX
National Provider Identifier
1972863314
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 23703
- Legal business name
- DENTAL DENTAL PLLC
- Practice address
- 11535 West Ave
San Antonio, TX 78213-1343 - Phone
- (210) 366-0100
- Fax
- (210) 366-0103
- NPI assigned
- May 19, 2012
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Medhat G Bader, D.D.S.
- Title
- Owner
- Phone
- (210) 366-0100
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 23703 | TX | Primary |
Addresses
Primary practice location
11535 West Ave
San Antonio, TX 78213-1343
Mailing address
11535 West Ave
San Antonio, TX 78213-1343
Phone (210) 366-0100
Other names 1
- Mr. Dentist
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1337385600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1358553600000",
"number": "1972863314",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11535 WEST AVE",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782131343",
"telephone_number": "210-366-0100",
"fax_number": "210-366-0103"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11535 WEST AVE",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782131343",
"telephone_number": "210-366-0100",
"fax_number": "210-366-0103"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DENTAL DENTAL PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2012-05-19",
"last_updated": "2013-01-19",
"status": "A",
"authorized_official_last_name": "BADER",
"authorized_official_first_name": "MEDHAT",
"authorized_official_middle_name": "G",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "210-366-0100",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "D.D.S."
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "23703",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Mr. Dentist",
"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 Jan 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.