NORTHEAST CHILDREN'S DENTISTRY, INC (NPI# 1356997126) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356997126 |
| Entity Type | Organization |
| Organization Name | NORTHEAST CHILDREN'S DENTISTRY, INC |
| Practice Address |
315 N San Saba Ste 202 San Antonio TX 78207-3193 |
| Practice Telephone | 2102233383 |
| Practice Fax Number | 2102231055 |
| Mailing Telephone | 2102233383 |
| Mailing Fax Number | 2102231055 |
| Enumeration Date | 2019-08-16 |
| Last Update Date | 2019-08-16 |
| Authorized Official Name | TRACEY HAY (PRACTICE COORDINATOR) |
| Authorized Official Telephone | 2106546882 |
| Is Organization Subpart | Y |
| Parent Organization Name | NORTHEAST CHILDREN'S DENTISTRY, INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | BLUE CROSS BLUE SHIELD | 00K78 | 01 |
| Other Name | Type Code |
|---|---|
| Northeast Children's Dentistry-Downtown Location | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033765094 | Northeast Children's Dentistry, Inc | Dentist | 21727 Ih 10 W Ste 203, San Antonio, TX 78257-2107 | 2019-08-15 |
| 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 |
| Street Address |
315 N SAN SABA STE 202 |
| City | SAN ANTONIO |
| State | TX |
| Zip Code | 78207-3193 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457999849 | Eri Industries, LLC, Dba Eri Group Homes | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2300 W. Commerce#216, San Antonio, TX 78207 | 2019-12-16 |
| 1164087854 | Jesse G Trevino | Student in an Organized Health Care Education/Training Program | 700 S Zarzamora Ste 209, San Antonio, TX 78207 | 2019-05-08 |
| 1669036869 | Anjali Patel | Student in an Organized Health Care Education/Training Program | 903 W. Martin Street, San Antonio, TX 78207 | 2019-04-24 |
| 1811488257 | Thomas Ellis Tippit Sr. | Dentist | 711 North Frio St, San Antonio, TX 78207 | 2018-05-22 |
| 1619426053 | Erica Annotti | Nurse Practitioner | 903 W Martin St Fl 6, San Antonio, TX 78207 | 2016-09-27 |
| 1801255435 | Mona Anwar El-kady | Audiologist | 411 S.w. 24th St, Jersig Building J119, San Antonio, TX 78207 | 2016-02-10 |
| 1053785683 | Lisa Marie Ramos | Speech-Language Pathologist | 230 Rounds, San Antonio, TX 78207 | 2015-11-19 |
| 1568840221 | Gabriel Tamayo | Physical Therapist | 701 S Zarzarmora, San Antonio, TX 78207 | 2015-05-14 |
| 1588042717 | Priya Amin | Podiatrist | 701 S Zarzamora St Ste 2120, San Antonio, TX 78207 | 2015-05-07 |
| 1437545837 | Jesse Banales | Student in an Organized Health Care Education/Training Program | 333 North Santa Road, Ccf-f3725, San Antonio, TX 78207 | 2015-04-13 |
| Find all providers in zip 78207 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| 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 |
| 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 |
| 1033765094 | Northeast Children's Dentistry, Inc | Dentist | 21727 Ih 10 W Ste 203, San Antonio, TX 78257-2107 | 2019-08-15 |
| 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 | ||||
| City | SAN ANTONIO |
| Zip Code | 78207 |
Please comment or provide details below to improve the information on NORTHEAST CHILDREN'S DENTISTRY, INC.
| 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.