is a Dental Clinic in San Antonio, Texas. This organization is also known as sub part of Southpark Family Dental Care. It is located at 6510 Babcock Rd, Suite 106, San Antonio, TX and its contact number is 210-558-7000. The authorized person for is Dr. Shiva Izaddoust
who is Owner of the clinic and their contact number is 210-927-1400. The primary license number for is 17028 (Dentist) in Texas. Clinic have dental surgeons who are specialized in dentistry, diagnosis, prevention, and treatment of diseases and conditions of the oral cavity. The dentist's supporting team aids in providing oral health services. The dental team includes dental assistants, dental hygienists, dental technicians, and sometimes dental therapists.
Complete Clinic Profile:
Clinic speciality, address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointments.
Name:
Specialization:
Dentistry
Clinic Address:
6510 Babcock Rd, Suite 106, San Antonio, Texas, 78249
Phone:
210-558-7000
Fax:
210-558-7001
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints for this clinic are as below. Person's position and contact details are also mentioned below.
Name:
Dr. Shiva Izaddoust
Position:
Owner
Contact Number:
210-927-1400
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details for clinic are as mentioned below.
NPI Number:
1720526163
Parent Organization:
Southpark Family Dental Care
NPI Enumeration Date:
06 Feb, 2017
NPI Last Update On:
06 Feb, 2017
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for are as mentioned below.
Specialization
License Number
State
Status
Dentist
17028
Texas
Primary
Other Medical Identifiers:
Other legacy medical identifiers of the clinic such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
Identifier
Type
State
Issuer
136343411
Medicaid
Texas
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
Address:
6510 Babcock Rd, Suite # 106 San Antonio, Texas
Zip:
78249
Phone Number:
210-558-7000
Fax Number:
210-558-7001
Patients can reach at 6510 Babcock Rd, Suite 106, San Antonio, Texas or can call to book an appointment on 210-558-7000. Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 10 February, 2025.