Provider Demographics
NPI:1124905997
Name:DANIELLE C DE LA PAZ DMD PC
Entity type:Organization
Organization Name:DANIELLE C DE LA PAZ DMD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:CECELIA
Authorized Official - Last Name:DE LA PAZ
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:210-818-0877
Mailing Address - Street 1:1100 NW LOOP 410 STE 360
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78213-2200
Mailing Address - Country:US
Mailing Address - Phone:210-818-0877
Mailing Address - Fax:
Practice Address - Street 1:540 MADISON OAK DR STE 441
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-3922
Practice Address - Country:US
Practice Address - Phone:210-545-2707
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-21
Last Update Date:2025-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty