NORTHEAST CHILDREN'S DENTISTRY, INC


Address: 21727 Ih 10 W Ste 203, San Antonio, TX 78257-2107
Phone: 2103144545

NORTHEAST CHILDREN'S DENTISTRY, INC (NPI# 1033765094) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1033765094
Entity Type Organization
Organization Name NORTHEAST CHILDREN'S DENTISTRY, INC
Other Organization Name NORTHEAST CHILDREN'S DENTISTRY-DOMINION CROSSING LOCATION
Practice Address 21727 Ih 10 W Ste 203
San Antonio
TX 78257-2107
Practice Telephone 2103144545
Practice Fax Number 2103144596
Mailing Telephone 2103144545
Enumeration Date 2019-08-15
Last Update Date 2019-08-15
Authorized Official Name TRACEY HAY (PRACTICE COORDINATOR)
Authorized Official Telephone 2106546882
Is Organization Subpart Y
Parent Organization Name NORTHEAST CHILDREN'S DENTISTRY, INC

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 1223P0221X Dentist
Specialization: Pediatric Dentistry
Dental Providers

Other Provider Identifier

State Issuer Identifier Type Code
TX BLUE CROSS BLUE SHIELD 00K78 01

Other Provider/Organization Names

Other Name Type Code
Northeast Children's Dentistry-Dominion Crossing Location Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1356997126 Northeast Children's Dentistry, Inc Dentist 315 N San Saba Ste 202, San Antonio, TX 78207-3193 2019-08-16
1245252238 Northeast Children's Dentistry, Inc Dentist 8606 Village Dr, Ste. B, San Antonio, TX 78217-5506 2006-07-25
1689220451 Northeast Children's Dentistry, Inc Dentist 4358 Thousand Oaks Dr, San Antonio, TX 78217-2102 2019-08-16
1013563972 Northeast Children's Dentistry, Inc Dentist 5000 Schertz Pkwy Ste 301, Schertz, TX 78154-1457 2019-08-15

Office Location

Street Address 21727 IH 10 W STE 203
City SAN ANTONIO
State TX
Zip Code 78257-2107

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1235737941 Barton Skinner Nurse Practitioner 17806 W I-10, Suite 300, San Antonio, TX 78257 2020-10-14
1639794464 Gabriel Ezequiel Cantu Behavior Technician 21727 I-10, Unit 108, San Antonio, TX 78257 2020-06-08
1588135719 Alejandro Daniel Perez Military Health Care Provider Wilderness Trl & Camp Bullis, San Antonio, TX 78257 2018-12-16
1386139434 Callie D Harris Nurse Practitioner 22135 I-10, San Antonio, TX 78257 2018-06-29
1093231326 Melissa Lauren Nguyen Military Health Care Provider 5425 Mc Williams Dr., Medical Aid Station Bldg 5425 Rm 104, San Antonio, TX 78257 2017-08-18
1902337165 Hania Alkudmani Dentist 24051 W Interstate 10, San Antonio, TX 78257 2017-03-21
1043767569 My Er Stcpr, Lp Clinic/Center 5431 North Loop 1604 West, San Antonio, TX 78257 2016-09-01
1649726381 Aaron Stares Physical Therapist 23127 Interstate Highway 10, Suite 203, San Antonio, TX 78257 2016-09-01
1457700023 Shelly Marquard Dietitian, Registered 22211 I-10 West, #1206, San Antonio, TX 78257 2016-06-06
1245695337 Ao Iom, Pllc Electrodiagnostic Medicine 17503 Lacantera Parkway Suite 104 # 422, San Antonio, TX 78257 2015-12-16
Find all providers in zip 78257

Taxonomy Information

Taxonomy Code 1223P0221X
Grouping Dental Providers
Classification Dentist
Specialization Pediatric Dentistry

Taxonomy Definition

An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
Notes: Source: Council on Dental Education and Licensure, American Dental Association

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1295344679 Bulverde Dental Specialist Pllc Dentist 22103 Bulverde Rd Ste 108, San Antonio, TX 78259-1855 2020-07-30
1407478027 Rittiman Pediatric Dentistry, Pllc Dentist 5723 N Foster Rd, San Antonio, TX 78244-1204 2020-05-18
1669011235 Kusom Pediatric Dental South Pllc Dentist 1134 Culebra Rd Ste 109, San Antonio, TX 78201-6080 2019-12-31
1114563590 Zaida Liliana Nieves Lopez Dentist 226 Serna Park, San Antonio, TX 78218-2035 2019-11-21
1356997126 Northeast Children's Dentistry, Inc Dentist 315 N San Saba Ste 202, San Antonio, TX 78207-3193 2019-08-16
1598310344 Celebraces Se Military Pllc Dentist 3611 Se Military Drive, Suite B101, San Antonio, TX 78223 2019-08-08
1972068401 Aventura Dental Dentist 11915 Perrin Beitel Rd, San Antonio, TX 78217-2127 2019-02-08
1427513316 San Antonio Pediatric Dentistry, Pllc Dentist 17026 Bulverde Rd Ste 102, San Antonio, TX 78247-4700 2019-02-05
1104394816 Cassandra Elkins Dds, Pllc Dentist 9543 Huebner Rd, San Antonio, TX 78240-1510 2018-11-12
1558849893 Purple Iris Dental Association Dentist 18010 Bulverde Rd Ste 112, San Antonio, TX 78259-3346 2018-07-30
Find all providers in SAN ANTONIO

Competitor

Search similar providers

City SAN ANTONIO
Zip Code 78257

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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