TATIANNA ALEXIS MCKISSICK DDS
NPI 1841056058
Dentist - General Practice in San Antonio, TX

Q: What is Tatianna Mckissick's NPI number?

The NPI number for Tatianna Mckissick is 1841056058. It was assigned to this individual provider in the NPPES registry on February 26, 2024.

Q: What is Tatianna Mckissick's specialty?

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

Active since February 26, 2024PECOS Enrolled

10103 W LOOP 1604 N STE 104, SAN ANTONIO, TX 78254(210) 495-2000 Get Directions Write a Review

NPPES record last updated: April 8, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 8, 2026, Jul 10, 2024, May 14, 2024 (3 updates tracked since 2024).

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About Tatianna Alexis Mckissick Dds NPPES

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

TATIANNA ALEXIS MCKISSICK DDS (NPI 1841056058) is an individual general practice provider in San Antonio, Texas, licensed in Texas (42045) and active in the NPI registry since February 2024. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1841056058

Entity TypeIndividualFemale

Primary Taxonomy1223G0001X

Provider Legal NameTATIANNA ALEXIS MCKISSICKCredential: DDS

Location Address10103 W LOOP 1604 N STE 104San Antonio, TX 78254-9716

Mailing Address10103 W Loop 1604 N Ste 104San Antonio, TX 78254-9716 · (210) 495-2000

Phone(210) 495-2000

Sole ProprietorNo

Enumeration DateFebruary 26, 2024

Last NPPES UpdateApril 8, 20263 updates tracked since enumeration

NPPES CertifiedApril 8, 2026

✔ NPI 1841056058 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers

Taxonomy Code1223G0001X

License✔ Licensed in TX · 42045

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.

10103 W LOOP 1604 N STE 104, San Antonio, TX 78254

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Tatianna Alexis Mckissick Dds is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 78254 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$84.92 typical visit price

range $54.84 – $166.88

Typical copayment $21.23 (range $13.71 – $41.72)

Most-billed visit code 99203

Established Patient

$68.55 typical visit price

range $17.52 – $136.11

Typical copayment $17.13 (range $4.38 – $34.02)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. NICHOLAS DYBDAL-HARGREAVES DDS, PHD

Dentist