Dental Studio

Primary specialty

DentistTaxonomy code 122300000X

License

0025123 Issued in TX

Legal business name

DENTAL STUDIO

Practice address

1671 Main St Ste B
Buda, TX 78610-9732

Phone

(512) 295-5777

Fax

(512) 295-5030

NPI assigned

Jun 18, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Ross M Koeppen, DDSNPI 1871790964

Title

Owner

Phone

(512) 295-5777

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ross M Koeppen, DDS

  • Dentist
  • Buda, TX
  • NPI 1871790964
  NPD (past) Authorized official

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

{
    "created_epoch": "1276819200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429574400000",
    "number": "1073834586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1671 MAIN ST STE B",
            "city": "BUDA",
            "state": "TX",
            "postal_code": "786109732",
            "telephone_number": "512-295-5777",
            "fax_number": "512-295-5030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1671 MAIN ST STE B",
            "city": "BUDA",
            "state": "TX",
            "postal_code": "786109732",
            "telephone_number": "512-295-5777",
            "fax_number": "512-295-5030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL STUDIO",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-18",
        "last_updated": "2015-04-21",
        "status": "A",
        "authorized_official_last_name": "KOEPPEN",
        "authorized_official_first_name": "ROSS",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "512-295-5777",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "TX",
            "license": "0025123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "213024701",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Monica Shavon Davis, FNP
• Vivian De la Fuentes
• D'Vaughn W Delpit, LCSW
• Natalie Demendonca-Rosales
• Dental Health Associates of Texas, PC (Budaful Dental Care)
• Kyle Derossett, DC
• Derrick D Flint, MD, DDS, PLLC (Oral Surgery Specialist of Buda)
• Connor Despot, D.M.D.
• Keaton Dir, DPT
• Tiffany Lauren Dixon, FNP-C

• Dentist in Buda, TX
• Providers in Buda, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2015; 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.