NORTH AUSTIN PEDIATRIC DENTAL, PLLC (NPI# 1215280557) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215280557 |
| Entity Type | Organization |
| Organization Name | NORTH AUSTIN PEDIATRIC DENTAL, PLLC |
| Other Organization Name | LONE STAR PEDIATRIC DENTAL |
| Practice Address |
8716 Research Blvd # 125 Austin TX 78758-6420 |
| Practice Telephone | 5124544646 |
| Practice Fax Number | 5124190561 |
| Mailing Telephone | 5124544646 |
| Mailing Fax Number | 5124190561 |
| Enumeration Date | 2012-10-24 |
| Last Update Date | 2012-10-24 |
| Authorized Official Name | MARTY MONTGOMERY (PRESIDENT) |
| Authorized Official Telephone | 5125746923 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
24217 | TX | Dental Providers |
| Other Name | Type Code |
|---|---|
| Lone Star Pediatric Dental | Doing Business As Name - Organization |
| Street Address |
8716 RESEARCH BLVD # 125 |
| City | AUSTIN |
| State | TX |
| Zip Code | 78758-6420 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225644065 | Seton Family of Doctors | Internal Medicine | 3001 Palm Way, D1 : 134-138, Austin, TX 78758 | 2020-09-17 |
| 1083243661 | Donna Bella Laurel Portillo | Pharmacist | 12221 N Mopac Expwy, Austin, TX 78758 | 2020-04-05 |
| 1881249092 | Elizabeth Logan Anderson | Behavioral Analyst | 2100 Kramer Ln., Suite 150, Austin, TX 78758 | 2019-08-05 |
| 1295388502 | Bridget Sue Morgan | Behavioral Analyst | 2100 Kramer Ln #150, Austin, TX 78758 | 2019-07-17 |
| 1508326885 | Jonathan James Runnels | Anesthesiologist Assistant | 12221n Mopac, Austin, TX 78758 | 2019-03-22 |
| 1427527324 | Nayely Gutierrez | Dietitian, Registered | 8606 Delaware Ct, Austin, TX 78758 | 2018-11-20 |
| 1720569635 | Shari Wright | Licensed Vocational Nurse | 12349 Metric Blvs # 425, Austin, TX 78758 | 2018-08-28 |
| 1528545456 | Alexis N Bongiorno | Registered Nurse | 11901 Hobby Horse Court, 1516, Austin, TX 78758 | 2018-07-24 |
| 1679072573 | Lori Scott | Counselor | 1600 Payton Gin Road, Austin, TX 78758 | 2018-02-06 |
| 1003322488 | Lisa Robyn Lee | Behavior Technician | 2018 W Rundberg Ln, #13d, Austin, TX 78758 | 2017-12-20 |
| Find all providers in zip 78758 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558832972 | Belterra Kids Teeth | Dentist | 165 Hargraves Dr Ste M100, Austin, TX 78737-4810 | 2018-12-11 |
| 1073051413 | Bash Braker LLC | Dentist | 1139 W Braker Ln, Ste 201, Austin, TX 78758 | 2017-02-06 |
| 1336519313 | Longhorn Pediatric Dentistry and Orthodontics | Dentist | 4638 W Gate Blvd, Austin, TX 78745-1461 | 2015-10-02 |
| 1659749810 | Specialty Dental Partners of Austin Pllc | Dentist | 4308 N Quinlan Park Rd Ste 201, Austin, TX 78732-6071 | 2015-09-04 |
| 1003202060 | Jared Poplin D.m.d., Pllc | Dentist | 6850 Austin Center Blvd Ste 220, Austin, TX 78731-3131 | 2015-04-07 |
| 1679964787 | Alexander Y Shau | Dentist | 13616 N Hwy 183 Unit A, Austin, TX 78750-2312 | 2015-02-10 |
| 1972902427 | Green Apple Pediatric Dentistry, Pllc | Dentist | 11601 Us Hwy 290 West, Suite 105, Austin, TX 78737 | 2014-08-21 |
| 1902216989 | Kyle Raymond Pa | Dentist | 5656 Bee Caves Rd Ste B104, Austin, TX 78746 | 2014-04-30 |
| 1447595855 | Rock That Smile Pediatric Dentistry Pllc | Dentist | 14005 N. Hwy 183, #800, Austin, TX 78717 | 2012-12-11 |
| 1467718577 | Gregory C. Thiel, Dds, Pllc | Dentist | 3775 S. Capital of Texas Hwy., Suite 292, Austin, TX 78704-7908 | 2012-04-03 |
| Find all providers in AUSTIN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.