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

Ingram Mall Dental Center, PLLC

Organization Dentist · NPI 1043541741

Ingram Mall Dental Center, PLLC is a Dentist 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
Phone: (210) 354-4867
Fax: (210) 681-6985
Show map & directions

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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