Lydian Dental Burnet PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5904 Issued in AZ

Legal business name

LYDIAN DENTAL BURNET PLLC

Practice address

5531 Burnet Rd
Austin, TX 78756

Phone

(480) 560-5183

NPI assigned

Feb 6, 2018

Organization subpart

No

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

Authorized official

Name

Pam Buckhanan

Title

Insurance Coordinator

Phone

(480) 560-5183

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Burnet Road Family Dental Doing business as

Locations

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

{
    "created_epoch": "1517875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1517875200000",
    "number": "1225537111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5531 BURNET RD",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78756",
            "telephone_number": "480-560-5183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5531 BURNET RD",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78756",
            "telephone_number": "480-560-5183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LYDIAN DENTAL BURNET PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-06",
        "last_updated": "2018-02-06",
        "status": "A",
        "authorized_official_last_name": "BUCKHANAN",
        "authorized_official_first_name": "PAM",
        "authorized_official_title_or_position": "INSURANCE COORDINATOR",
        "authorized_official_telephone_number": "480-560-5183"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "5904",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1144355629",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Burnet Road Family Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• LWD Investments
• Cedie Ly
• Chris Ly, O.D.
• Nicholas Ly
• Sean Thuong Ly, DC
• Lydian Dental Lamar PLLC
• Kennon Lydick, RD, LD
• Kara Lydzinski
• Cara Lye, MD
• Yi-Rui Lye

• 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 Feb 6, 2018; 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.