LSPD at Circle C, PLLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

LSPD AT CIRCLE C, PLLC

Doing business as

Lone Star Pediatric Dental

Practice address

5900 W Slaughter LN Ste 470
Austin, TX 78749-6513

Phone

(512) 206-2929

NPI assigned

Feb 2, 2017

Organization subpart

No

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

Authorized official

Name

Marty Montgomery, DMD

Title

Owner

Phone

(512) 206-2975

Specialties & licenses 2

Addresses

Other names 1

• Lone Star Pediatric Dental Doing business as

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

{
    "created_epoch": "1485993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485993600000",
    "number": "1104364710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 E HUNTLAND DR STE 340",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787523745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5900 W SLAUGHTER LN STE 470",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787496513",
            "telephone_number": "512-206-2929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LSPD AT CIRCLE C, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-02",
        "last_updated": "2017-02-02",
        "status": "A",
        "authorized_official_last_name": "MONTGOMERY",
        "authorized_official_first_name": "MARTY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "512-206-2975",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lone Star Pediatric Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Pediatric Dentistry in Austin, TX
• Providers in Austin, TX by specialty
• Pediatric Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2017; 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.