Unknown Individual – General Practice Dentistry, NPI 1629049317

Unknown Individual is a healthcare provider. based in Lackland afb, Texas. specializing in General Practice Dentistry. They hold a License No. 11142 (TX). The NPI Number for Unknown Individual is 1629049317

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1629049317
Phone
(210) 292-7282
Address
220 BERQUIST DRIVE
Deactivation Date
30 January 2025
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

Provider Addresses for Unknown Individual

  • 220 BERQUIST DRIVE

    SUITE 1

    LACKLAND AFB, TX 782365300

    Phone: (210) 292-7282

    Type: Location

  • 810, Toepperwein Road, Converse, Bexar County, Texas, 78109, United States

    CONVERSE, TX 781092306

    Phone: (409) 963-2725

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 78236)

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Reviews

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Frequently asked questions

Is there an official ID for Unknown Individual in U.S. healthcare records?
The official identifier for Unknown Individual is NPI 1629049317.
Can Unknown Individual still bill if the NPI is inactive?
Do not rely on inactive status alone — contact the provider for confirmation.
What expertise is attributed to Unknown Individual?
Unknown Individual's specialty line reads General Practice Dentistry. Clinical services aligned with this taxonomy classification.
What practice footprint exists for Unknown Individual?
Travel planning: use Lackland Afb, Texas as the reference point for Unknown Individual, then confirm.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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