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

Kusom Dental Broadway PLLC

Organization General Practice Dentistry · NPI 1265204622

Kusom Dental Broadway PLLC is a General Practice Dentistry in San Antonio, Texas. Registered with an NPI since 2023.

In the registry since
2023
Specialties on file
2
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

8852 Broadway # 201
San Antonio, TX 78217-6318
Phone: (210) 888-0700
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X
Dental Clinic/Center Taxonomy 261QD0000X

Record details

NPI number1265204622
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Selinda Gonzalez — Office Manager · (210) 888-0700
NPI enumeratedOctober 27, 2023
Last updated in NPPESMay 20, 2024
Certification dateMay 20, 2024
Mailing address18707 Hardy Oak Blvd Ste 305, San Antonio, TX 78258-4895

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