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NPI Code Detail

MEDICARE: PARK OAKS DENTAL

MEDICARE: PARK OAKS DENTAL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QD0000XDental Clinic/Center

General Provider Information

NPI Number : 1700581154
Entity Type Code : Organization
Provider Name (Legal Business Name) : PARK OAKS DENTAL
Provider Business Mailing Address
First Line : 16616 SAN PEDRO AVE
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78232-2223
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 16616 SAN PEDRO AVE
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78232-2223
Country : US
Telephone Number : 210-491-9898
Fax Number :
Authorized Official
Title or Position : OWNER DENTIST
Name : VANDAN DESAI
Credential : DDS
Telephone Number : 210-547-6440
Provider Enumeration Date : 04/04/2023
Last Update Date : 04/04/2023

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Directions to “PARK OAKS DENTAL ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.