NPIMap

Individual provider Active NPI

Alexandra Barton Otto, DDS

  • Pediatric Dentistry
  • Buda, TX
National Provider Identifier
1043552029
Registry record updated Jun 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
31521 Issued in TX
Practice address
1245 Main Street, BLDG B-2
Suite 300
Buda, TX 78610
Phone
(303) 944-8045
NPI assigned
Mar 18, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 202183 CO
Pediatric Dentistry 1223P0221X 31521 TX Primary

Addresses

Primary practice location

1245 Main Street, BLDG B-2
Suite 300
Buda, TX 78610

Mailing address

1245 Main Street, BLDG B-2
Suite 300
Buda, TX 78610
Phone (303) 944-8045

Other identifiers 1

IdentifierTypeStateIssuer
3507097MedicaidTX

Other names 1

  • Dr. Blanche Alexandra Barton Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
31521TXMDClinical Psychologist
202183COMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Childrens Hospital Pediatric Dentistry PLLC Pediatric Dentistry Current Accepting new patients
Steiner Ranch Pediatric Dentistry Pediatric Dentistry Current Accepting new patients
Kids Tooth Team Pflugerville PLLC Pediatric Dentistry Current Accepting new patients

Locations

1245 Main St
Ste 300
Buda, TX 78610
Phone (303) 944-8045

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1363564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592870400000",
    "number": "1043552029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1245 MAIN STREET, BLDG B-2",
            "address_2": "SUITE 300",
            "city": "BUDA",
            "state": "TX",
            "postal_code": "78610",
            "telephone_number": "303-944-8045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1245 MAIN STREET, BLDG B-2",
            "address_2": "SUITE 300",
            "city": "BUDA",
            "state": "TX",
            "postal_code": "78610",
            "telephone_number": "303-944-8045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTTO",
        "first_name": "ALEXANDRA",
        "middle_name": "BARTON",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-18",
        "last_updated": "2020-06-23",
        "certification_date": "2020-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CO",
            "license": "202183",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TX",
            "license": "31521",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3507097",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BLANCHE",
            "last_name": "BARTON",
            "middle_name": "ALEXANDRA",
            "prefix": "DR.",
            "credential": "DDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Buda, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.