Provider Demographics
NPI:1710687975
Name:NADER, CELINE MIREILLE (DDS)
Entity type:Individual
Prefix:
First Name:CELINE
Middle Name:MIREILLE
Last Name:NADER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24531 IH 10 W STE 101
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78257-1541
Mailing Address - Country:US
Mailing Address - Phone:210-687-6929
Mailing Address - Fax:
Practice Address - Street 1:24531 IH 10 W STE 101
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78257-1541
Practice Address - Country:US
Practice Address - Phone:210-640-9230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-07
Last Update Date:2025-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TX41505122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program