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SOUTHSIDE CHILDREN'S DENTAL CENTER P.C. NPI 1902815335


NPI Information

NPI: 1902815335
Provider Name: SOUTHSIDE CHILDREN'S DENTAL CENTER, P.C.

Former Legal Business Name: SCOTT HEBERT DDS

Classification: Dentist - 1223P0221X
Entity Type: Organization

Specialization: Pediatric Dentistry

Address:
125 SW MILITARY DR
SAN ANTONIO, TX
ZIP 78221
Phone: (210) 922-3483
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SOUTHSIDE CHILDREN'S DENTAL CENTER, P.C. is a pediatric dentistry dentist in San Antonio, TX. The provider is an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. SOUTHSIDE CHILDREN'S DENTAL CENTER, P.C. NPI is 1902815335. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Former Legal Business Name Is Scott Hebert Dds.

The provider's business location address is:

125 SW MILITARY DR
SAN ANTONIO, TX
ZIP 78221-650
Phone: (210) 922-3483
Fax: (210) 922-8902

The provider's authorized official is Doris Coderre-zercher .
The authorized official title is Office Manager and has the following contact phone number (210) 922-3483.

The enumeration date for this NPI number is 8/5/2006 and was last updated on 10/21/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223G0001XDentistGeneral PracticeNo
21223S0112XDentistOral and Maxillofacial SurgeryNo
31223X0400XDentistOrthodontics and Dentofacial OrthopedicsNo
41223P0221XDentistPediatric DentistryYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1126722102MEDICAIDTEXAS
2695123OTHERTEXASUNITED CONCORDIA
3007874OTHERTEXASDELTA CARE
438644OTHERTEXASUNITED HEALTHCARE
584D747OTHERTEXASBLUECROSS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.