Access Dental of Rundberg

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

ACCESS DENTAL OF RUNDBERG

Practice address

825 E Rundberg LN
Suite a-1
Austin, TX 78753-4808

Phone

(512) 837-0200

NPI assigned

Mar 21, 2008

Organization subpart

No

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

Authorized official

Name

Tien Dinh Phan, DMD

Title

Owner

Phone

(512) 837-0200

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1206057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635120000000",
    "number": "1265603856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8150 SPRINGWOOD DR # 150B",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750635810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 E RUNDBERG LN",
            "address_2": "SUITE A-1",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787534808",
            "telephone_number": "512-837-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACCESS DENTAL OF RUNDBERG",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-21",
        "last_updated": "2021-10-25",
        "certification_date": "2021-10-25",
        "status": "A",
        "authorized_official_last_name": "PHAN",
        "authorized_official_first_name": "TIEN",
        "authorized_official_middle_name": "DINH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "512-837-0200",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2021; 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.