NPIMap

Organization Active NPI

Northwest Dental Associates P.a.

  • General Practice Dentistry
  • Cedar Park, TX
National Provider Identifier
1093196644
Registry record updated Jun 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
18096 Issued in TX
Legal business name
NORTHWEST DENTAL ASSOCIATES P.A.
Practice address
11066 Pecan Park Blvd.
Suite #411
Cedar Park, TX 78613
Phone
(512) 219-7484
Fax
(512) 219-6505
NPI assigned
Jun 9, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2015

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

Authorized official

Name
Mr. Toai C. Pham, D.D.S.NPI 1689718959
Title
Doctor/Owner
Phone
(512) 219-7484

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 18096 TX Primary

Addresses

Primary practice location

11066 Pecan Park Blvd.
Suite #411
Cedar Park, TX 78613

Mailing address

11066 Pecan Park Blvd.
Suite #411
Cedar Park, TX 78613
Phone (512) 219-7484

National Provider Directory

National Provider Directory

Locations

11066 Pecan Park Blvd
Ste 411
Cedar Park, TX 78613
Phone (512) 219-7484

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1433808000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433808000000",
    "number": "1093196644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11066 PECAN PARK BLVD.",
            "address_2": "SUITE #411",
            "city": "CEDAR PARK",
            "state": "TX",
            "postal_code": "78613",
            "telephone_number": "512-219-7484",
            "fax_number": "512-219-6505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11066 PECAN PARK BLVD.",
            "address_2": "SUITE #411",
            "city": "CEDAR PARK",
            "state": "TX",
            "postal_code": "78613",
            "telephone_number": "512-219-7484",
            "fax_number": "512-219-6505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST DENTAL ASSOCIATES P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-09",
        "last_updated": "2015-06-09",
        "status": "A",
        "authorized_official_last_name": "PHAM",
        "authorized_official_first_name": "TOAI",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "DOCTOR/OWNER",
        "authorized_official_telephone_number": "512-219-7484",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "18096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Park, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 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.