Provider Demographics
NPI:1275289506
Name:INSPIRE DENTAL
Entity Type:Organization
Organization Name:INSPIRE DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDRE
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:210-705-4030
Mailing Address - Street 1:1901 BABCOCK RD STE 201
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-4546
Mailing Address - Country:US
Mailing Address - Phone:210-734-5092
Mailing Address - Fax:210-898-8435
Practice Address - Street 1:1901 BABCOCK RD STE 201
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-4546
Practice Address - Country:US
Practice Address - Phone:210-734-5092
Practice Address - Fax:210-898-8435
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-24
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1043851405Medicaid