Niva Dental Specialists PLLC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

NIVA DENTAL SPECIALISTS PLLC

Practice address

15141 Ronald Reagan Blvd
Suite 516
Leander, TX 78641-7864

Phone

(512) 881-8852

Fax

(512) 881-7721

NPI assigned

Dec 6, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Shouvik Ponnusamy, DMDNPI 1457706202

Title

Owner

Phone

(630) 267-1199

Specialties & licenses 3

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Shouvik Ponnusamy, DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • Round Rock, TX
  • NPI 1457706202
  NPD Authorized official
• Lilia Marcela Ferral

  • Periodontics
  • Austin, TX
  • NPI 1164914685
  NPD (past)

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

{
    "created_epoch": "1670284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670284800000",
    "number": "1194436634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1511 RIMSTONE DR",
            "city": "CEDAR PARK",
            "state": "TX",
            "postal_code": "786137692",
            "telephone_number": "630-267-1199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15141 RONALD REAGAN BLVD",
            "address_2": "SUITE 516",
            "city": "LEANDER",
            "state": "TX",
            "postal_code": "786417864",
            "telephone_number": "512-881-8852",
            "fax_number": "512-881-7721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NIVA DENTAL SPECIALISTS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-06",
        "last_updated": "2022-12-06",
        "certification_date": "2022-12-02",
        "status": "A",
        "authorized_official_last_name": "PONNUSAMY",
        "authorized_official_first_name": "SHOUVIK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-267-1199",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christelle Tuyet Minh Nguyen, OD
• Dennis My Nguyen
• Huy Huu Nguyen
• Megan Nguyen
• Nion Behavioral Health, PLLC
• Nluc PLLC
• Kristen Nordeen, LPC-A
• North Austin Physical Therapy, LLC
• Jennifer Norton, COTA
• Makenzee Wrayann Nowak, COTA/L

• Oral and Maxillofacial Surgery (Dentist) in Leander, TX
• Providers in Leander, TX by specialty
• Oral and Maxillofacial Surgery (Dentist) in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 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.