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KUSOM DENTAL BROADWAY PLLC
NPI 1265204622
Dentist - General Practice in San Antonio, TX

Active since October 27, 2023
8852 BROADWAY # 201, SAN ANTONIO, TX 78217(210) 888-0700 Get Directions Write a Review

NPPES record last updated: May 20, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 7, 2023, Oct 27, 2023 (2 updates tracked since 2023).

About Kusom Dental Broadway Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KUSOM DENTAL BROADWAY PLLC (NPI 1265204622) is a healthcare organization registered as a general practice in San Antonio, Texas and active in the NPI registry since October 2023. The organization lists Selinda Gonzalez, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1265204622
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameKUSOM DENTAL BROADWAY PLLC
Location Address8852 BROADWAY # 201San Antonio, TX 78217-6318
Mailing Address18707 Hardy Oak Blvd Ste 305San Antonio, TX 78258-4895 · (210) 888-0700 · Fax (210) 625-7398
Phone(210) 888-0700
Organization SubpartNo
Authorized OfficialSelinda GonzalezOffice Manager · (210) 888-0700
Enumeration DateOctober 27, 2023
Last NPPES UpdateMay 20, 20242 updates tracked since enumeration
NPPES CertifiedMay 20, 2024
✔ NPI 1265204622 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
Also ListedClinic/Center · DentalTaxonomy 261QD0000X
8852 BROADWAY # 201, San Antonio, TX 78217
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kusom Dental Broadway PLLC's NPI number?

The NPI number for Kusom Dental Broadway PLLC is 1265204622. It was assigned to this organization in the NPPES registry on October 27, 2023.

Where is Kusom Dental Broadway PLLC located?

Kusom Dental Broadway PLLC is located at 8852 Broadway # 201, San Antonio, TX 78217. The listed phone number is (210) 888-0700.

What is Kusom Dental Broadway PLLC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

When was this NPI record last updated?

The NPPES record for Kusom Dental Broadway PLLC was last updated on May 20, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.