CROWNRIDGE DENTAL (NPI# 1962028142) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962028142 |
| Entity Type | Organization |
| Organization Name | CROWNRIDGE DENTAL |
| Practice Address |
6827 Camp Bullis Rd Ste 302 San Antonio TX 78256-1730 |
| Practice Telephone | 2105387500 |
| Practice Fax Number | 2105697750 |
| Enumeration Date | 2020-06-23 |
| Last Update Date | 2020-06-23 |
| Authorized Official Name | CHRISTIAN ALEXANDER PHAM (OWNER) |
| Authorized Official Telephone | 2105387500 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QS0112X |
Clinic/Center Specialization: Oral and Maxillofacial Surgery |
Ambulatory Health Care Facilities |
| Street Address |
6827 CAMP BULLIS RD STE 302 |
| City | SAN ANTONIO |
| State | TX |
| Zip Code | 78256-1730 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073127692 | Lucinda Geeslin | Social Worker | Oak Hills Church Care and Growth Center, 6929 Camp Bullis Road, San Antonio, TX 78256 | 2020-09-01 |
| 1558916155 | Kathleen Anne Champie | Physical Therapist | 6909 Heuermann Rd, San Antonio, TX 78256 | 2019-08-09 |
| 1861956138 | Arianna Kay Antunez | Optometrist | 15900 La Cantera Pkwy Ste 9915, San Antonio, TX 78256 | 2019-01-30 |
| 1447714274 | Suzanne Perakathu | Nurse Practitioner | 7122 Stonewall Hill, San Antonio, TX 78256 | 2019-01-25 |
| 1114499548 | Myriam Noemi Villarreal | Speech-Language Pathologist | 326 Waxberry Trl, San Antonio, TX 78256 | 2018-12-25 |
| 1013488626 | Campus Bullis Primary Care | Clinic/Center | 6865 Camp Bullis, Suite 201, San Antonio, TX 78256 | 2018-12-07 |
| 1063929792 | Rehabcare Group East, LLC | Clinic/Center | Isle At Watercrest Dominion, 6906 Heuermann Road, San Antonio, TX 78256 | 2018-01-03 |
| 1275932022 | Wg Kirby Pllc | Dentist | 17101 Lacantera Parkway, Bldg 8 Suite 122, San Antonio, TX 78256 | 2014-08-18 |
| 1477893352 | John Mirelez | Pharmacist | 24165 Ih 10, San Antonio, TX 78256 | 2013-02-28 |
| 1831469048 | Cvs Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 15607 Chase Hill Blvd, San Antonio, TX 78256 | 2012-01-04 |
| Find all providers in zip 78256 | ||||
| Taxonomy Code | 261QS0112X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| 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 |
|---|---|---|---|---|
| 1063987626 | River City Oral and Maxillofacial Surgery, Pllc | Clinic/Center | 5418 N Loop 1604 E, Suite 101, San Antonio, TX 78023 | 2018-10-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811491244 | Stephen Barker Dds Pllc | Clinic/Center | 9803 Highway 242 Ste 700, Conroe, TX 77385-4370 | 2018-03-21 |
| 1144758954 | Telfair Oral and Maxillofacial Surgery Pllc | Clinic/Center | 13440 University Blvd Ste 250, Sugar Land, TX 77479-4798 | 2017-05-24 |
| 1255719100 | South Houston Oral,facial&implant Surgery Center | Clinic/Center | 2537 Houston Ave, Pearland, TX 77581-4231 | 2015-05-12 |
| 1578973483 | Mazen Duraini, Dds, Md, Pllc | Clinic/Center | 6753 Cabrillo, Irving, TX 75039-3223 | 2014-04-30 |
| 1912221029 | Sharon H Ornstein, Dds, Pa | Clinic/Center | 6351 N Preston Rd, Suite 200, Fisco, TX 75034 | 2010-03-18 |
| 1437397148 | Oral & Maxillofacial Surgery Affiliates, P.C. | Clinic/Center | 7030 Sanger Ave, Suite 100, Waco, TX 76712 | 2009-02-03 |
| 1912150111 | Waterford Dental Specialists, Pllc | Clinic/Center | 5246 S. 31st St., Temple, TX 76502 | 2008-10-31 |
| 1790778314 | Aesthetic Oral & Facial Surgical Center of The Southwest, PC | Clinic/Center | 1850 Keller Pkwy, Suite 102, Keller, TX 76248-3706 | 2005-08-30 |
| 1396344933 | Twtsa, LLC. | Clinic/Center | 6025 Harris Pkwy, Fort Worth, TX 76132-4103 | 2020-10-24 |
| 1790218782 | Aoms Outpatient Surgery, Pllc | Clinic/Center | 5051 S Soncy Rd, Amarillo, TX 79119-6667 | 2017-04-06 |
| Find all providers with the same taxonomy | ||||
| City | SAN ANTONIO |
| Zip Code | 78256 |
Please comment or provide details below to improve the information on CROWNRIDGE DENTAL.
| 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.