River Rock Pediatric Dentistry, PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

23496 Issued in TX

Legal business name

RIVER ROCK PEDIATRIC DENTISTRY, PC

Practice address

5900 W Slaughter LN
Suite 470
Austin, TX 78749-6511

Phone

(512) 462-4775

Fax

(512) 462-4782

NPI assigned

Aug 19, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Jackson Booth, DDS

Title

Owner

Phone

(512) 739-9440

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1439942400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439942400000",
    "number": "1235505702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5717 S IH 35",
            "address_2": "BLDG B, SUITE 101",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787442711",
            "telephone_number": "512-462-4775",
            "fax_number": "512-462-4782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5900 W SLAUGHTER LN",
            "address_2": "SUITE 470",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787496511",
            "telephone_number": "512-462-4775",
            "fax_number": "512-462-4782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVER ROCK PEDIATRIC DENTISTRY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-19",
        "last_updated": "2015-08-19",
        "status": "A",
        "authorized_official_last_name": "BOOTH",
        "authorized_official_first_name": "JACKSON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "512-739-9440",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "23496",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• River Place Dental
• River Rock - Airport, P.C. (River Rock Dental)
• River Rock -Mueller PC (River Rock Dental - Mueller)
• River Rock Dental - Lamar PC (River Rock Dental - Lamar)
• River Rock Dental, P.C. (River Rock Dental)
• Hilary Rivera Alvarado
• Marilyn Rivera Carrasco
• Alma Rosa Rivera Feregrino, MD, MPH
• Laura Rivera Martin, FNP
• Yessica Lizbeth Rivera Trujillo

• 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 19, 2015; 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.