Provider Demographics
NPI:1245228535
Name:BEDNARIK, VANESSA FRANCES (DDS)
Entity Type:Individual
Prefix:DR
First Name:VANESSA
Middle Name:FRANCES
Last Name:BEDNARIK
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:430 W LOOP 1604 N STE 109
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78251-3343
Mailing Address - Country:US
Mailing Address - Phone:210-566-3123
Mailing Address - Fax:
Practice Address - Street 1:12710 W IH 10 STE 120
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78230-1002
Practice Address - Country:US
Practice Address - Phone:210-836-9920
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-11
Last Update Date:2021-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY7922122300000X
NY0524991223G0001X
TX25082122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice