SONTORA MAX PA (NPI# 1972709343) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972709343 |
| Entity Type | Organization |
| Organization Name | SONTORA MAX PA |
| Other Organization Name | SONTERRA ORAL AND MAXILLOFACIAL SURGERY CENTER |
| Practice Address |
1202 East Sonterra Blvd Suite 801 San Antonio TN 78258 |
| Practice Telephone | 2104942005 |
| Practice Fax Number | 2104941332 |
| Mailing Telephone | 2104942005 |
| Mailing Fax Number | 2104941332 |
| Enumeration Date | 2007-06-22 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | ROBERT BRYAN ROACH JR. (ORAL SURGEON) |
| Authorized Official Telephone | 2104942005 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
22140 | TX | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NPI PROVIDER | 1972562312 | 01 | |
| NPI PROVIDER | 1134188576 | 01 |
| Other Name | Type Code |
|---|---|
| Sonterra Oral and Maxillofacial Surgery Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013113562 | Sontora Max Pa | Dentist | 1202 East Sonterra Blvd, Suite 801, San Antonio, TN 78258 | 2007-06-22 |
| Street Address |
1202 EAST SONTERRA BLVD SUITE 801 |
| City | SAN ANTONIO |
| State | TN |
| Zip Code | 78258 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134188576 | David Ventura Malave | Dentist | 1202 East Sonterra Blvd, Suite 801, San Antonio, TX 78258 | 2006-03-23 |
| 1013113562 | Sontora Max Pa | Dentist | 1202 East Sonterra Blvd, Suite 801, San Antonio, TN 78258 | 2007-06-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356980163 | Jeffrey M. Martinez, M.d., P.a. | Surgery | 525 Centre Oak Drive, Suite 140, San Antonio, TX 78258 | 2019-12-26 |
| 1588226211 | New Life Brace and Limb, LLC | Prosthetist | 300 E. Sonterra Blvd., Suite 220, San Antonio, TX 78258 | 2019-07-02 |
| 1720649080 | Miguel Ibarra | Pharmacist | 18866 Stone Oak Pkwy., St.101, San Antonio, TX 78258 | 2019-06-26 |
| 1528538113 | Kevin Scott Farnsworth | Dentist | 1130 E. Sonterra Blvd Suite 100, San Antonio, TX 78258 | 2018-11-27 |
| 1891262176 | Dentists of Stone Oak, PC | Dentist | 23714 Hardy Oak Blvd, Suite 110, San Antonio, TX 78258 | 2018-10-25 |
| 1003399437 | Jesus Alcala | Physical Therapist | 20821 Us Hwy 281 N, Ste 110, San Antonio, TX 78258 | 2018-09-11 |
| 1184106544 | Marissa Kaye Bruton | Occupational Therapist | 505 Madison Oak, San Antonio, TX 78258 | 2018-09-02 |
| 1508346933 | Desiree Carroll | Occupational Therapy Assistant | 18803 Hardy Oak Drive, San Antonio, TX 78258 | 2018-08-15 |
| 1700376456 | Conner Jay Mcnabb | Optometrist | 810 Knights Cross Dr Ste 101, San Antonio, TX 78258 | 2018-05-17 |
| 1982191516 | Freehand Solutions LLC | Chiropractor | Nec Stone Oak Parkway & Loop 1604, San Antonio, TX 78258 | 2018-04-19 |
| Find all providers in zip 78258 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568080497 | San Antonio Wisdom Teeth, Pllc | Dentist | 13535 Hausman Pass #102-a, San Antonio, TX 78249 | 2020-07-07 |
| 1023596061 | Albert L. Ouellette, Dds, Pllc | Dentist | 1202 E Sonterra Blvd Ste 801, San Antonio, TX 78258-4095 | 2018-08-01 |
| 1154726131 | Rafael Antonio Gavilanes | Dentist | 1005 Ave General Ramey Ste 1, San Antonio, PR 00690 | 2014-11-03 |
| 1952710949 | Ryan M Leonhart Dds Md Pllc | Dentist | 6530 W Loop 1604 N, Suite 101, San Antonio, TX 78254-6319 | 2014-08-05 |
| 1023424090 | Jabir Alhumaid | Dentist | 7703 Floyd Curl Dr # Mc7908, Oral and Maxillofacial Surgery Uthscsa, San Antonio, TX 78229-3901 | 2014-07-10 |
| 1013292614 | Glen A Fritz | Dentist | 16789 N Us Highway 281, Your Ortho Team, PC, San Antonio, TX 78232-2349 | 2011-10-14 |
| 1699065383 | Patricia E. Lopez | Dentist | 7703 Floyd Drive - Dept. Oral & Maxillofacial Surgery, University of Texas Health Science Center At San Antoni, San Antonio, TX 78229-3900 | 2011-04-14 |
| 1962734160 | J. Andrew Jackson, D.d.s. Ltd., LLP | Dentist | 600 Division, Suite E., San Antonio, TX 78214 | 2010-02-12 |
| 1508097817 | Daniel Enrique Perez | Dentist | 8210 Floyd Curl Dr Dept Oral, San Antonio, TX 78229-3923 | 2009-08-04 |
| 1871787291 | Adam Joseph Verrett | Dentist | 4499 Medical Dr Ste 190, San Antonio, TX 78229-3768 | 2007-08-29 |
| Find all providers in SAN ANTONIO | ||||
| City | SAN ANTONIO |
| Zip Code | 78258 |
Please comment or provide details below to improve the information on SONTORA MAX PA.
| 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.