NPIMap

Organization Active NPI

Carus Dental PC

Doing business as Carus Surgical Center Round Rock

  • Oral and Maxillofacial Surgery (Dentist)
  • Round Rock, TX
National Provider Identifier
1114477353
Registry record updated Jan 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
15919 Issued in TX
Legal business name
CARUS DENTAL PC
Doing business as
Carus Surgical Center Round Rock
Practice address
16000 Park Valley Dr Ste 160
Round Rock, TX 78681-4009
Phone
(512) 733-8308
Fax
(512) 310-0451
NPI assigned
Oct 12, 2016
Last updated
Jan 19, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
CARUS DENTAL PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 19, 2022

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

Authorized official

Name
Celia Hayes
Title
Credentialing Coordinator
Phone
(217) 540-2100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 15919 TX Primary

Addresses

Primary practice location

16000 Park Valley Dr Ste 160
Round Rock, TX 78681-4009

Mailing address

16000 Park Valley Dr Ste 160
Round Rock, TX 78681-4009
Phone (512) 733-8308

Other names 1

  • Carus Surgical Center Round Rock Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Longorn Dental41 organizations share this tax ID, including this one
Part of
Longorn Dental

Other organizations with this tax ID 40

Organizations that report the same tax identification number in the National Provider Directory.

View all 40

Locations

16000 Park Valley Dr
Ste 160
Round Rock, TX 78681
Phone (512) 341-7373

Practitioners & affiliated clinicians

Practitioners 2

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": "1476230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642550400000",
    "number": "1114477353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16000 PARK VALLEY DR STE 160",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786814009",
            "telephone_number": "512-733-8308",
            "fax_number": "512-310-0451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16000 PARK VALLEY DR STE 160",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786814009",
            "telephone_number": "512-733-8308",
            "fax_number": "512-310-0451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARUS DENTAL PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CARUS DENTAL PC",
        "enumeration_date": "2016-10-12",
        "last_updated": "2022-01-19",
        "certification_date": "2022-01-19",
        "status": "A",
        "authorized_official_last_name": "HAYES",
        "authorized_official_first_name": "CELIA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-2100"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "15919",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Carus Surgical Center Round Rock",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Round Rock, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2022; 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.