NPI age
19 years
Enumerated 2006-11-09
● Active Type 2 · Organization
Modern Dental Professionals San Antonio Pc
Modern Dental Professionals San Antonio Pc is 1 of 9237 dentist organizations in Texas.
Primary specialty
Dentist
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Ervin
Owner
Last NPPES update
2016-12-07
Source: monthly bulk 2026-05
How this organization compares
Across 9237 active dentist providers in Texas.
NPI age
19 years
↑ 7 yr above median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2006 → 2026
2006-11Enumerated in NPPES
2006
2026
Where they practice
Primary practice location
17700 San Pedro Ave, Suite 320
San Antonio, TX 782321404
Mailing address
8415 Datapoint Dr, Suite 1020
San Antonio, TX 782293298
Authorized official
Marcus Ervin, DDS
Owner
📞 2106534867
Individual providers at this organization
2 individual providers on file at this primary practice address.
- Kimberly Hanysak Dentist NPI 1124188289
- Melodie Wallace, O.D. Optometrist NPI 1124147954
Specialties
-
Dentist PrimaryA dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two...
Other names on file (1)
Doing-business-as, former, and alternate names recorded by NPPES.
-
Castle Dental
Practice context
Multi-provider organization. 2 individual providers on file at this primary address.
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- 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.