Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Ingram Mall Dental Center, PLLC

Organization Dentist · NPI 1043541741

Ingram Mall Dental Center, PLLC provides Dentist services in San Antonio, Texas. Licensed in Texas. Registered with an NPI since 2010.

Licensed in
TX
In the registry since
2010
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

6301 NW Loop 410 L1A
San Antonio, TX 78238-3824 Not confirmed with CMS for 16 years — call before visiting
Phone: (210) 354-4867
Fax: (210) 681-6985
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence 15889 (TX)

Record details

NPI number1043541741
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Bertha Rodriguez — Regional Manager · (210) 354-4867
NPI enumeratedJanuary 19, 2010
Last updated in NPPESJanuary 19, 2010
Mailing address6301 Nw Loop 410, L1a, San Antonio, TX 78238-3824

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