Individual provider Active NPI

Jason Thomas Carlyon, DDS

  • Dentist
  • Austin, TX
National Provider Identifier
1083049696
Registry record updated Sep 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
20904 Issued in TX
Practice address
8118 Shoal Creek Blvd
Austin, TX 78757-8041
Phone
(512) 452-8262
Fax
(512) 420-8265
NPI assigned
Sep 13, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 13, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 20904 TX Primary

Addresses

Primary practice location

8118 Shoal Creek Blvd
Austin, TX 78757-8041

Mailing address

8118 Shoal Creek Blvd
Austin, TX 78757-8041
Phone (512) 452-8262

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
20904TXMDCounseling Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Tana M Busch DDS PLLC Past Accepting new patients
8118 Dental Professionals PLLC Dentist PastSince Apr 6, 2023 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": "1379030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379030400000",
    "number": "1083049696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8118 SHOAL CREEK BLVD",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787578041",
            "telephone_number": "512-452-8262",
            "fax_number": "512-420-8265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8118 SHOAL CREEK BLVD",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787578041",
            "telephone_number": "512-452-8262",
            "fax_number": "512-420-8265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLYON",
        "first_name": "JASON",
        "middle_name": "THOMAS",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-09-13",
        "last_updated": "2013-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "20904",
            "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 Sep 13, 2013; 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.