NPIMap

Organization Active NPI

River Rock Dental - Lockhart PC

Doing business as River Rock Dental - Lockhart

  • General Practice Dentistry
  • Lockhart, TX
National Provider Identifier
1265874499
Registry record updated Jul 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
23496 Issued in TX
Legal business name
RIVER ROCK DENTAL - LOCKHART PC
Doing business as
River Rock Dental - Lockhart
Practice address
1906 S. Colorado
Suite 110
Lockhart, TX 78644
Phone
(512) 820-6927
Fax
(512) 389-9797
NPI assigned
Jul 30, 2013
Last updated
Jul 30, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2013

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

Authorized official

Name
Dr. Jackson Booth, DDSNPI 1891987368
Title
Owner
Phone
(512) 739-9440

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 23496 TX Primary

Addresses

Primary practice location

1906 S. Colorado
Suite 110
Lockhart, TX 78644

Mailing address

4410 E Riverside Dr
Suite 150
Austin, TX 78741-4799
Phone (512) 385-4700

Other names 1

  • River Rock Dental - Lockhart Doing business as

National Provider Directory

National Provider Directory

Locations

1906 S Colorado St
Ste 110
Lockhart, TX 78644
Phone (512) 213-1681

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1375142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375142400000",
    "number": "1265874499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4410 E RIVERSIDE DR",
            "address_2": "SUITE 150",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787414799",
            "telephone_number": "512-385-4700",
            "fax_number": "512-389-9797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1906 S. COLORADO",
            "address_2": "SUITE 110",
            "city": "LOCKHART",
            "state": "TX",
            "postal_code": "78644",
            "telephone_number": "512-820-6927",
            "fax_number": "512-389-9797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVER ROCK DENTAL - LOCKHART PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-30",
        "last_updated": "2013-07-30",
        "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": [
        {
            "organization_name": "River Rock Dental - Lockhart",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lockhart, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2013; 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.