Kelli C. Mack, D.D.S.

General Practice Dentistry · Jbsa Lackland, TX

Individual Active NPI

NPI number 1679515696

Practice location

1615 Truemper St
Jbsa Lackland, TX 78236-5511
Phone
(210) 539-7022

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NPI record

NPI
1679515696
Entity type
Individual (Type 1)
Enumeration date
June 12, 2006
Last updated
March 2, 2023
Certified
March 1, 2023
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
General Practice Dentistry Primary 1223G0001X 44021 CA
Dentist 122300000X 44021 CA
General Practice Dentistry 1223G0001X 21967 TX

Mailing address

1615 Truemper St
Lackland Afb, TX 78236-5511
Phone
(210) 539-7011

Other practice locations (1)

  • 3551 Rodger Brooke Dr., San Antonio, TX 78219 · (210) 916-4141

About Dr. Mack

Kelli C. Mack, D.D.S. is a healthcare provider registered in the NPI registry with the primary taxonomy General Practice Dentistry (code 1223G0001X). The practice location is 1615 Truemper St, Jbsa Lackland, TX 78236-5511. The NPI number 1679515696 was assigned on June 12, 2006 and the record was last updated on March 2, 2023.

Dr. Mack lists 3 licenses in the registry: #44021 (CA) for General Practice Dentistry; #44021 (CA) for Dentist; #21967 (TX) for General Practice Dentistry. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Kelli C. Mack, D.D.S.?

The NPI number is 1679515696.

What is the phone number of Dr. Mack?

The phone number listed for the practice location is (210) 539-7022.

Where is Dr. Mack located?

1615 Truemper St, Jbsa Lackland, TX 78236-5511.

What is the taxonomy code for Dr. Mack?

The primary taxonomy code is 1223G0001X – General Practice Dentistry; 2 more listed above.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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