BLUEBONNET ORAL SURGERY AND IMPLANTS PLLC (NPI# 1033550983) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033550983 |
| Entity Type | Organization |
| Organization Name | BLUEBONNET ORAL SURGERY AND IMPLANTS PLLC |
| Practice Address |
7300 Blanco Rd Suite 100 San Antonio TX 78216-4936 |
| Practice Telephone | 2103449898 |
| Practice Fax Number | 2103449118 |
| Mailing Telephone | 2103449898 |
| Mailing Fax Number | 2103449118 |
| Enumeration Date | 2013-07-08 |
| Last Update Date | 2013-07-08 |
| Authorized Official Name | GREG RANDOLPH (DENTIST) |
| Authorized Official Telephone | 2103449898 |
| 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 |
12316 | TX | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | DENTAL LICENSE NUMBER | 12316 | 01 |
| TX | DENTAL LICENSE NUMBER | 14522 | 01 |
| Street Address |
7300 BLANCO RD SUITE 100 |
| City | SAN ANTONIO |
| State | TX |
| Zip Code | 78216-4936 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548258932 | Irv Loev | Counselor | 7300 Blanco Rd, Suite 201, San Antonio, TX 78216-4936 | 2005-10-10 |
| 1598366288 | Amy M Krauss | Massage Therapist | 7300 Blanco Rd, San Antonio, TX 78216-4936 | 2020-11-08 |
| 1740827682 | Peter Burns | Chiropractor | 7300 Blanco Rd, San Antonio, TX 78216-4936 | 2019-12-10 |
| 1841731833 | Marilyn Caylor | Counselor | 7300 Blanco Rd, Suite 501, San Antonio, TX 78216-4936 | 2017-03-10 |
| 1336503077 | Shawna Marie Corley | Counselor | 7300 Blanco Rd, Suite 501, San Antonio, TX 78216-4936 | 2016-04-08 |
| 1588072102 | Suzanne Holt | Counselor | 7300 Blanco Rd, San Antonio, TX 78216-4936 | 2014-07-28 |
| 1225453392 | Clara Naomi Aragon | Counselor | 7300 Blanco Rd, Suite 501, San Antonio, TX 78216-4936 | 2014-02-26 |
| 1053736124 | Lauren Del Angel-walker | Student in an Organized Health Care Education/Training Program | 7300 Blanco Rd, Suite 501, San Antonio, TX 78216-4936 | 2014-02-26 |
| 1801211081 | Elizabeth Krenek | Counselor | 7300 Blanco Rd, Ste 501, San Antonio, TX 78216-4936 | 2014-02-25 |
| 1679900088 | Thomas C Shields | Dentist | 7300 Blanco Rd, Suite 203, San Antonio, TX 78216-4936 | 2013-09-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376179820 | Damiana Lea Mcmahan | Speech-Language Pathologist | 12 Inter Park Blvd, #105, San Antonio, TX 78216 | 2020-03-17 |
| 1811530967 | Hacienda Hospice, Ltd | Hospice Care, Community Based | 101 W Silver Sands Dr, San Antonio, TX 78216 | 2019-10-22 |
| 1437792876 | Eddy Sidra | Optometrist | 7400 San Pedro Avenue, Suite 486, San Antonio, TX 78216 | 2019-10-17 |
| 1083256796 | Tiffany Michelle Goericke | Physical Therapist | 502 East Ramsey, San Antonio, TX 78216 | 2019-10-14 |
| 1780246942 | Esperanza Eating Disorders Center, Pllc | Clinic/Center | 403 E. Ramsey, Suite 204, San Antonio, TX 78216 | 2019-07-08 |
| 1568938314 | Lyric Lea Lewis | Licensed Vocational Nurse | 85 Ne Interstate 410 Loop #500, San Antonio, TX 78216 | 2018-10-19 |
| 1912488206 | Rebecca Anna Poppe | Licensed Vocational Nurse | 1514 Vista Del Norte, San Antonio, TX 78216 | 2018-08-24 |
| 1205338779 | Bailee Hannah Mokry | Behavioral Analyst | 11306 Sir Winston, San Antonio, TX 78216 | 2018-03-01 |
| 1487155677 | Ojer Corbie | Behavior Technician | 11310 Sir Winston At Bld D, San Antonio, TX 78216 | 2018-02-23 |
| 1366943631 | Briana Nicole Rodriguez | Behavior Technician | 14235 Blanco Road, San Antonio, TX 78216 | 2018-02-22 |
| Find all providers in zip 78216 | ||||
| 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 | 78216 |
Please comment or provide details below to improve the information on BLUEBONNET ORAL SURGERY AND IMPLANTS PLLC.
| 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.