Individual provider Active NPI

Alyssa Ceja Dawson, DDS

  • General Practice Dentistry
  • Austin, TX
National Provider Identifier
1063905446
Registry record updated Jun 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
34022 Issued in TX
Practice address
165 Hargraves Dr Ste 200
Austin, TX 78737-4795
Phone
(512) 758-8655
NPI assigned
Jun 11, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 34022 TX Primary

Addresses

Primary practice location

165 Hargraves Dr Ste 200
Austin, TX 78737-4795

Mailing address

6401 Rialto Blvd Apt 16010
Austin, TX 78735-0055
Phone (817) 808-9953

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
34022TXMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Groovy Dental PLLC Current Accepting new patients
Groovy Sleep PLLC Current Accepting new patients

Organizations & group practices 2

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": "1528675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528675200000",
    "number": "1063905446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6401 RIALTO BLVD APT 16010",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787350055",
            "telephone_number": "817-808-9953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 HARGRAVES DR STE 200",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787374795",
            "telephone_number": "512-758-8655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAWSON",
        "first_name": "ALYSSA",
        "middle_name": "CEJA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-11",
        "last_updated": "2018-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "34022",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2018; 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.