360 Dental Care P.a.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

16292 Issued in TX

Legal business name

360 DENTAL CARE P.A.

Practice address

3660 Stoneridge Rd Ste B101
Austin, TX 78746-7759

Phone

(512) 327-3631

Fax

(512) 327-2234

NPI assigned

Nov 16, 2006

Organization subpart

No

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

Authorized official

Name

Michael B Nussbaum, D.D.S.

Title

President

Phone

(512) 327-3631

Specialties & licenses 1

Addresses

Other names 1

• Michael B. Nussbaum D.D.S. Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1154494250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3660 STONERIDGE RD STE B101",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787467759",
            "telephone_number": "512-327-3631",
            "fax_number": "512-327-2234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3660 STONERIDGE RD STE B101",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787467759",
            "telephone_number": "512-327-3631",
            "fax_number": "512-327-2234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "360 DENTAL CARE P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NUSSBAUM",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "512-327-3631",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "16292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Michael B. Nussbaum D.D.S.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Dentistry in Austin, TX
• Providers in Austin, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.