Provider Demographics
NPI:1568522647
Name:MCLENDON, ERIN ALAYNE (DDS)
Entity Type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:ALAYNE
Last Name:MCLENDON
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 1:15909 SAN PEDRO AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-3743
Mailing Address - Country:US
Mailing Address - Phone:210-494-4011
Mailing Address - Fax:210-494-4896
Practice Address - Street 1:15909 SAN PEDRO AVE STE 200
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-3743
Practice Address - Country:US
Practice Address - Phone:210-494-4011
Practice Address - Fax:210-494-4896
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2018-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX205451223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX300000901OtherBLUE CROSS BLUE SHIELD
TX001355668OtherUNITED CONCORDIA INSURANC
TX20545OtherDELTA DENTAL INSURANCE
TX1635948-01Medicaid