Organization Active NPI

Derby Family Dental PLLC

Doing business as Derby Dental

  • General Practice Dentistry
  • Austin, TX
National Provider Identifier
1083490825
Registry record updated Jun 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
DERBY FAMILY DENTAL PLLC
Doing business as
Derby Dental
Practice address
3410 Far West Blvd Ste 340
Austin, TX 78731-3272
Phone
(512) 795-0128
NPI assigned
Sep 7, 2023
Last updated
Jun 26, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2026

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

Authorized official

Name
Dr. William R Jennings, DDS
Title
Owner
Phone
(940) 206-8956

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

3410 Far West Blvd Ste 340
Austin, TX 78731-3272

Mailing address

2109 Commerce St Ste 200
Dallas, TX 75201-4350
Phone (972) 248-1221

Other names 1

  • Derby Dental Doing business as

National Provider Directory

National Provider Directory

Locations

3410 Far West Blvd
Ste 340
Austin, TX 78731
Phone (512) 795-0128

Practitioners & affiliated clinicians

Practitioners 1

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": "1694044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782432000000",
    "number": "1083490825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2109 COMMERCE ST STE 200",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752014350",
            "telephone_number": "972-248-1221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3410 FAR WEST BLVD STE 340",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787313272",
            "telephone_number": "512-795-0128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERBY FAMILY DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-07",
        "last_updated": "2026-06-26",
        "certification_date": "2026-06-26",
        "status": "A",
        "authorized_official_last_name": "JENNINGS",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "940-206-8956",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Derby Dental",
            "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 Jun 26, 2026; 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.