NPIMap

Organization Active NPI

Windcrest Pediatric Dentistry

  • Pediatric Dentistry
  • San Antonio, TX
National Provider Identifier
1982964839
Registry record updated Oct 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
24209 Issued in TX
Legal business name
WINDCREST PEDIATRIC DENTISTRY
Practice address
5500 Walzem Rd
San Antonio, TX 78218-2103
Phone
(210) 657-4641
Fax
(210) 655-4012
NPI assigned
May 25, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2012

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

Authorized official

Name
Sylvester C. Awagu, DMDNPI 1700049806
Title
Owner
Phone
(210) 657-4641

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
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X 24209 TX Primary

Addresses

Primary practice location

5500 Walzem Rd
San Antonio, TX 78218-2103

Mailing address

5500 Walzem Rd
San Antonio, TX 78218-2103
Phone (210) 657-4641

National Provider Directory

National Provider Directory

Locations

5500 Walzem Rd
Windcrest, TX 78218
Phone (210) 657-4641

Practitioners & affiliated clinicians

Practitioners 1

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": "1337904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349913600000",
    "number": "1982964839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 WALZEM RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782182103",
            "telephone_number": "210-657-4641",
            "fax_number": "210-655-4012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 WALZEM RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782182103",
            "telephone_number": "210-657-4641",
            "fax_number": "210-655-4012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WINDCREST PEDIATRIC DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-25",
        "last_updated": "2012-10-11",
        "status": "A",
        "authorized_official_last_name": "AWAGU",
        "authorized_official_first_name": "SYLVESTER",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "210-657-4641",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TX",
            "license": "24209",
            "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 Oct 11, 2012; 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.