MISSION PLAZA DENTAL PLLC (NPI# 1104110501) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104110501 |
| Entity Type | Organization |
| Organization Name | MISSION PLAZA DENTAL PLLC |
| Other Organization Name | SMILE STRUCTURE |
| Practice Address |
3454 Roosevelt Ave. San Antonio TX 78214 |
| Practice Telephone | 2105461337 |
| Practice Fax Number | 2105461348 |
| Mailing Telephone | 2105461337 |
| Mailing Fax Number | 2105461348 |
| Enumeration Date | 2011-06-02 |
| Last Update Date | 2011-06-02 |
| Authorized Official Name | DR. ANDREW THOMAS SCRAVER (OWNER) |
| Authorized Official Telephone | 2105461337 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
22951 | TX | Dental Providers |
| Other Name | Type Code |
|---|---|
| Smile Structure | Doing Business As Name - Organization |
| Street Address |
3454 ROOSEVELT AVE. |
| City | SAN ANTONIO |
| State | TX |
| Zip Code | 78214 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104380245 | Mission Event Senior Center LLC | Clinic/Center | 5614 South Flores Street, San Antonio, TX 78214 | 2019-01-23 |
| 1396239497 | Allen Ray Williams II | Chiropractor | 6000 Farm To Market 3009, Ste 200, San Antonio, TX 78214 | 2018-06-21 |
| 1326482027 | Rolando Gonzalez | Specialist/Technologist, Other | 1131 91st St, San Antonio, TX 78214 | 2013-04-24 |
| 1235425463 | Roberto Issac Cortez | Dentist | 3454 Roosevelt Avenue, San Antonio, TX 78214 | 2011-06-27 |
| 1982904561 | Amir Ahmed | Pharmacist | 119 Huizar Street, Cyctic Fibrosis Services, San Antonio, TX 78214 | 2010-10-28 |
| 1962734160 | J. Andrew Jackson, D.d.s. Ltd., LLP | Dentist | 600 Division, Suite E., San Antonio, TX 78214 | 2010-02-12 |
| 1881805653 | Bruce Lee Vetters | Dentist | 6619 S Flores, San Antonio, TX 78214 | 2007-05-24 |
| 1053403147 | John D Cochran Dds Inc | Dentist | 5713 South Flores, San Antonio, TX 78214 | 2006-09-28 |
| 1306945415 | Idalia Ivanna Benavides | Specialist | 161 Tommins Ave., San Antonio, TX 78214 | 2006-09-22 |
| 1598134157 | Erin Forsythe | Physical Therapist | 730 Pleasanton Rd, San Antonio, TX 78214 | 2015-09-24 |
| Find all providers in zip 78214 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306452354 | Cesar Oscar Gonzalez | Dentist | 20122 Stone Oak Pkwy Ste 101, San Antonio, TX 78258-7041 | 2020-09-16 |
| 1760093397 | Grace Jie Zhang | Dentist | 11535 West Ave # A, San Antonio, TX 78213-1343 | 2020-08-17 |
| 1104436831 | Tian Meng | Dentist | 8110 W Loop 1604 N, San Antonio, TX 78254-2104 | 2020-08-07 |
| 1780217976 | Tovar Dental, Pllc | Dentist | 11840 Alamo Ranch Parkway, #90, San Antonio, TX 78253 | 2020-02-17 |
| 1972133767 | Evodent Dental Pllc | Dentist | 18838 Stone Oak Pkwy Ste 102, San Antonio, TX 78258-4179 | 2020-01-21 |
| 1659901502 | Dental Care of San Antonio, Pllc | Dentist | 115 N Loop 1604 E Ste 1104, San Antonio, TX 78232-1399 | 2020-01-20 |
| 1437792041 | Precision Smile Structure Culebra Pllc | Dentist | 6626 W Loop 1604 N Ste 216, San Antonio, TX 78254-6602 | 2019-10-26 |
| 1013558998 | Great White Dental Pllc | Dentist | 238 Sw Military Dr Ste 104, San Antonio, TX 78221-1657 | 2019-10-02 |
| 1376192443 | Deborah R. Keepers Dds Pa | Dentist | 11309 Bandera Rd Ste 101, San Antonio, TX 78250-2602 | 2019-09-10 |
| 1487202750 | Western Dental Care | Dentist | 2347 Nw Military Hwy Ste 101, San Antonio, TX 78231-2502 | 2019-08-29 |
| Find all providers in SAN ANTONIO | ||||
| City | SAN ANTONIO |
| Zip Code | 78214 |
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| 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.