Provider Demographics
NPI:1073947461
Name:UNDER THE SEA CHILDREN'S DENTISTRY, P.C
Entity Type:Organization
Organization Name:UNDER THE SEA CHILDREN'S DENTISTRY, P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PEDIATRIC DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:NATASCHA
Authorized Official - Middle Name:ELENA
Authorized Official - Last Name:ARISMENDI SARABIA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:210-862-6458
Mailing Address - Street 1:24015 BRIARBROOK WAY
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78261-2686
Mailing Address - Country:US
Mailing Address - Phone:210-314-1830
Mailing Address - Fax:210-314-1830
Practice Address - Street 1:8340 FM 78
Practice Address - Street 2:SUITE #8
Practice Address - City:CONVERSE
Practice Address - State:TX
Practice Address - Zip Code:78109-1080
Practice Address - Country:US
Practice Address - Phone:210-314-1830
Practice Address - Fax:210-314-1830
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-21
Last Update Date:2013-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX255871223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty