NPIMap

Organization Active NPI

Van Dyke Dental Associates, PA

  • General Practice Dentistry
  • Austin, TX
National Provider Identifier
1194039396
Registry record updated Jul 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
23148 Issued in TX
Legal business name
VAN DYKE DENTAL ASSOCIATES, PA
Practice address
730 W Stassney LN
Suite 110
Austin, TX 78745-2982
Phone
(512) 744-6000
Fax
(512) 583-9679
NPI assigned
Jul 29, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2010

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

Authorized official

Name
Karen Cantu
Title
Credentialing Specialist
Phone
(512) 583-9679

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 23148 TX Primary

Addresses

Primary practice location

730 W Stassney LN
Suite 110
Austin, TX 78745-2982

Mailing address

2621 Ridgepoint Dr
Suite 130
Austin, TX 78754-5232
Phone (512) 744-6000

National Provider Directory

National Provider Directory
Tax ID family
Van Dyke Dental Associates PA6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

NPI Registry JSON

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

{
    "created_epoch": "1280361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280361600000",
    "number": "1194039396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2621 RIDGEPOINT DR",
            "address_2": "SUITE 130",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787545232",
            "telephone_number": "512-744-6000",
            "fax_number": "512-334-2321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 W STASSNEY LN",
            "address_2": "SUITE 110",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787452982",
            "telephone_number": "512-744-6000",
            "fax_number": "512-583-9679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VAN DYKE DENTAL ASSOCIATES, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-29",
        "last_updated": "2010-07-29",
        "status": "A",
        "authorized_official_last_name": "CANTU",
        "authorized_official_first_name": "KAREN",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "512-583-9679"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "23148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2010; 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.