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South Park Family Dental Care PA

Dental Clinic/Center in San Antonio, TX · enumerated 2007 · authorized official Shiva Izaddoust, President.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1467586768

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Registry record

Entity type Organization (Type 2)
Legal business name South Park Family Dental Care PA
Practice address 2310 Sw Military Dr, Ste 406, San Antonio, TX, 78224
Phone (210) 927-1400
Fax (210) 927-6330
Enumeration date Mar 16, 2007
Last updated in NPPES May 24, 2011

Taxonomy & classification

261QD0000X Dental Clinic/Center Ambulatory Health Care Facilities Primary

Authorized official

Name Shiva Izaddoust
Title President
Phone (210) 927-1400

Other identifiers

Identifier Type State Issuer
G60126-3 Other TX TEXAS CHIP
0064GJ Other TX BLUE CROSS BLUE SHIELD
1300537 Other TX UNITED CONCORDIA
0099152-01 Medicaid TX -

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

What is the NPI number for South Park Family Dental Care PA?
The NPI for South Park Family Dental Care PA is 1467586768, a Type 2 (organization) record in the CMS NPPES registry.
Who is the authorized official for South Park Family Dental Care PA?
NPPES lists Shiva Izaddoust (President) as the authorized official for this organization.

Providers at this address

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2011-05-24.