NPIMap

Organization Active NPI

Marc Amsili DDS PA

Doing business as Omni Dental Group

  • General Practice Dentistry
  • Austin, TX
National Provider Identifier
1073611273
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
16471 Issued in TX
Legal business name
MARC AMSILI DDS PA
Doing business as
Omni Dental Group
Practice address
1110 W William Cannon Dr
Suite 401
Austin, TX 78745-5468
Phone
(512) 445-5012
Fax
(512) 445-5721
NPI assigned
Sep 20, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Marc A Amsili, DDS, PANPI 1669547832
Title
Owner
Phone
(512) 250-5012

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 16471 TX Primary

Addresses

Primary practice location

1110 W William Cannon Dr
Suite 401
Austin, TX 78745-5468

Mailing address

1110 W William Cannon Dr
Suite 401
Austin, TX 78745-5468
Phone (512) 445-5012

Other names 1

  • OMNI DENTAL GROUP Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Omni Dental Group3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1110 W William Cannon Dr
Ste 401
Austin, TX 78745
Phone (512) 445-5012

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1073611273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 W WILLIAM CANNON DR",
            "address_2": "SUITE 401",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787455468",
            "telephone_number": "512-445-5012",
            "fax_number": "512-445-5721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 W WILLIAM CANNON DR",
            "address_2": "SUITE 401",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787455468",
            "telephone_number": "512-445-5012",
            "fax_number": "512-445-5721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARC AMSILI DDS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "AMSILI",
        "authorized_official_first_name": "MARC",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "512-250-5012",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, PA"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "16471",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OMNI DENTAL GROUP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Aug 22, 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.