Organization · Type 2 NPI

SP Administration

Dentist · San Antonio, TX

NPI number 1720526163 Active

Practice location

6510 Babcock Rd, Suite 106
San Antonio, TX 78249

Fax (210) 558-7001

Specialties and licenses

Taxonomy	Code	License
Dentist Primary	122300000X	17028 (TX)

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…

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NPI record

NPI: 1720526163
Entity type: Organization (Type 2)
Issued: Feb 6, 2017
Last updated: Feb 6, 2017
Status: Active
Subpart: Yes of Southpark Family Dental Care

Other names

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Springtime Family Dental Care · doing business as

Authorized official

Dr. Shiva Izaddoust, DDS
Owner
(210) 927-1400

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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.

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About NPI 1720526163

SP Administration's National Provider Identifier is 1720526163, issued on Feb 6, 2017. The primary taxonomy on file is Dentist (122300000X), and the practice location is in San Antonio, TX. The record was last updated on Feb 6, 2017.