Lone Star Pediatric Dental and Braces

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

24217 Issued in TX

Legal business name

LONE STAR PEDIATRIC DENTAL AND BRACES

Practice address

4201 Marathon Blvd
302
Austin, TX 78756-3436

Phone

(512) 206-2929

NPI assigned

May 21, 2013

Organization subpart

No

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

Authorized official

Name

Marty Montgomery, D.M.D.

Title

Owner

Phone

(512) 420-8889

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1369094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386201600000",
    "number": "1124464813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 MARATHON BLVD",
            "address_2": "302",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787563436",
            "telephone_number": "512-206-2929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 MARATHON BLVD",
            "address_2": "302",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787563436",
            "telephone_number": "512-206-2929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONE STAR PEDIATRIC DENTAL AND BRACES",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-21",
        "last_updated": "2013-12-05",
        "status": "A",
        "authorized_official_last_name": "MONTGOMERY",
        "authorized_official_first_name": "MARTY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "512-420-8889",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "TX",
            "license": "24217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lone Star Dental Care PLLC
• Lone Star Endoscopy of Austin, PLLC
• Lone Star Eye PLLC
• Lone Star Oncology Consultants, PA
• Lone Star Orthodontics, P.a.
• Lone Star Pediatric Dental, PLLC
• Lone Star Urogynecology and Continence Center, PLLC
• Lone Star Urology PLLC
• Gael Lonergan, MD
• Lonestar Anesthesia of Austin, PLLC

• Orthodontics and Dentofacial Orthopedics Dentistry in Austin, TX
• Providers in Austin, TX by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 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.