NPI age
19 years
Enumerated 2007-03-16
● Active Type 2 · Organization
South Park Family Dental Care PA
South Park Family Dental Care PA is 1 of 1762 clinic/center organizations in Texas.
Primary specialty
Clinic/Center
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Izaddoust
President
Last NPPES update
2011-05-24
Source: monthly bulk 2026-05
How this organization compares
Across 1762 active clinic/center providers in Texas.
NPI age
19 years
↑ 13 yr above median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2007 → 2026
2007-03Enumerated in NPPES
2007
2026
Where they practice
Primary practice location
2310 Sw Military Dr, Ste 406
San Antonio, TX 782241407
Mailing address
2310 Sw Military Dr, Ste 406
San Antonio, TX 782241407
Authorized official
Shiva Izaddoust, D.D.S.
President
📞 2109271400
Individual providers at this organization
7 individual providers on file at this primary practice address.
- Brenda Alvarado, O.D. Optometrist NPI 1467477836
- Eugene Alvarado, O.D. Optometrist NPI 1376567214
- Victor Alvarado Technician/Technologist NPI 1811086119
- Linda Braun, O.D. Optometrist NPI 1376678755
- Vesta Broumand-Mizani, D.D.S. Dentist NPI 1609060599
- Suhail Daraiseh, DC Chiropractor NPI 1669721320
- Shiva Izaddoust, D.D.S. Dentist NPI 1649317421
Specialties
-
Clinic/Center PrimaryDefinition to come...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | G60126-3 | TEXAS CHIP |
| 01 (TX) | 0064GJ | BLUE CROSS BLUE SHIELD |
| 01 (TX) | 1300537 | UNITED CONCORDIA |
| 05 (TX) | 0099152-01 |
Practice context
Multi-provider organization. 7 individual providers on file at this primary address.
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Request a quote →How to verify this organization
- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Verify the organization is in good standing.Cross-check with the state's business registration and any applicable licensing boards.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.