Tx Southern Dental PPO PC
NPI 1063300960ActiveOrganization· Dentist, Periodontics· San Antonio, TX
Dentist, Periodontics in San Antonio, Texas, registered in NPPES in June 2025, part of Tx Southern Dental PPO PC. The authorized official on file is Erika Melissa Menjivar, Sr. Credentialing Specialist.
Overview
| NPI | 1063300960 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Tx Southern Dental PPO PC |
| NPI issued | Jun 27, 2025 |
| Last updated in NPPES | Jun 27, 2025 |
| Certified by provider | Jun 27, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist, Periodontics Primary | 1223P0300X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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