=====================================================
General NPI Number Information
=====================================================
NPI Number | 1124905997
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DANIELLE C DE LA PAZ DMD PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/21/2025
-----------------------------------------------------
Last Update Date | 08/21/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 540 MADISON OAK DR STE 441
-----------------------------------------------------
City | SAN ANTONIO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78258-3922
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 210-545-2707
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1100 NW LOOP 410 STE 360
-----------------------------------------------------
City | SAN ANTONIO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78213-2200
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 210-818-0877
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DENTIST
-----------------------------------------------------
Name | DR. DANIELLE CECELIA DE LA PAZ
-----------------------------------------------------
Credential | DMD
-----------------------------------------------------
Telephone | 210-818-0877
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223G0001X
-----------------------------------------------------
Taxonomy Name | General Practice Dentistry
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------