Organization · Type 2 NPI

TX Southern Dental Ppo PC

Dentist · San Antonio, TX

NPI number 1336056233 Active

Practice location

4807 Fredericksburg Rd
San Antonio, TX 78229-3627

Call (210) 341-3181 Map

Mailing address

5830 Granite Pkwy Ste 780
Plano, TX 75024-6775

Specialties and licenses

Taxonomy	Code	License
Dentist Primary	122300000X	None listed

Dentist: A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requiremen…

3 other providers at this address

Other dentist providers in San Antonio

See all in San Antonio →

NPI record

NPI: 1336056233
Entity type: Organization (Type 2)
Issued: Aug 26, 2026
Last updated: Aug 26, 2026
Status: Active
Subpart: Yes of TX Southern Dental Ppo PC

Other names

Michael Miller DDS · doing business as

Authorized official

Erika Melissa Menjivar
Sr. Credentialing Specialist
(469) 596-6137

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

Is this your record? How to update it.

About NPI 1336056233

TX Southern Dental Ppo PC's National Provider Identifier is 1336056233, issued on Aug 26, 2026. The primary taxonomy on file is Dentist (122300000X), and the practice location is in San Antonio, TX. The record was last updated on Aug 26, 2026.