# DEZAVALA FAMILY DENTAL, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1376085712
- **Authorized official:** DR. ANDIA NADIMI DMD (PRESIDENT)
- **Authorized official phone:** (210) 696-7885

## Contact information

- **Practice address:** 5563 DE ZAVALA RD, 160, SAN ANTONIO, TX 78249-1734
- **Practice address phone:** (210) 696-7885
- **Mailing address:** 5563 DE ZAVALA RD STE 160, SAN ANTONIO, TX 78249-1738
- **Mailing address phone:** (210) 696-7885

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 26540 | TX | Yes |

## Other

- **Enumeration date:** 11/16/2016
- **Last updated:** 11/16/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 28162330 | — | TX |