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General NPI Number Information
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NPI Number | 1619835535
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Entity Type | Organization
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Legal Business Name | KAIROS DENTAL GROUP, PLLC
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Dates
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Enumeration Date | 01/10/2026
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Last Update Date | 01/10/2026
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Provider Practice Location Address
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Address Line | 3414 ROOSEVELT AVE
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City | SAN ANTONIO
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State | TX
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Zip | 78214-2606
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Country | US
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Telephone | 210-909-5502
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Fax |
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Provider Business Mailing Address
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Address Line | 4115 POND HILL RD STE 102
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City | SHAVANO PARK
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State | TX
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Zip | 78231-1285
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Country | US
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Telephone | 210-909-5502
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Fax |
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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | DR. JOSHUA MIJARES
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Credential | DDS
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Telephone | 210-909-5502
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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