Individual provider Active NPI

Yazmin J. Miranda, D.M.D

  • General Practice Dentistry
  • Round Rock, TX
National Provider Identifier
1255790622
Registry record updated May 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
31746 Issued in TX
Practice address
1025 Sendero Springs Dr Ste 170
Round Rock, TX 78681-1153
Phone
(512) 710-7226
NPI assigned
Feb 15, 2016
Last updated
May 15, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 31746 TX Primary

Addresses

Primary practice location

1025 Sendero Springs Dr Ste 170
Round Rock, TX 78681-1153

Mailing address

1025 Sendero Springs Dr Ste 170
Round Rock, TX 78681-1153
Phone (512) 710-7226

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
31746TXMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
RR Adc PLLC General Practice CurrentSince May 19, 2024 Accepting new patients
Crescent Dental-San Marcos PLLC PastSince Jun 21, 2022 Accepting new patients

Locations

1025 Sendero Springs Dr
Ste 170
Round Rock, TX 78681
Phone (512) 710-7226

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1455494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715731200000",
    "number": "1255790622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 SENDERO SPRINGS DR STE 170",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786811153",
            "telephone_number": "512-710-7226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 SENDERO SPRINGS DR STE 170",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786811153",
            "telephone_number": "512-710-7226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRANDA",
        "first_name": "YAZMIN",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-15",
        "last_updated": "2024-05-15",
        "certification_date": "2024-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "31746",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Round Rock, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2024; 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.