NPIMap

Organization Active NPI

Lone Star Dental Anesthesia

  • Dental Anesthesiology
  • Richardson, TX
National Provider Identifier
1295210573
Registry record updated Oct 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental AnesthesiologyTaxonomy code 1223D0004X
Legal business name
LONE STAR DENTAL ANESTHESIA
Practice address
4112 E Renner Rd
Richardson, TX 75082-2832
Phone
(972) 536-3972
NPI assigned
Oct 2, 2018
Last updated
Oct 2, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2018

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

Authorized official

Name
Jinsoo Kim, DDSNPI 1316019995
Title
Owner
Phone
(972) 536-3972

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
Dental AnesthesiologyGroup: 193400000X SINGLE SPECIALTY GROUP 1223D0004X Primary

Addresses

Primary practice location

4112 E Renner Rd
Richardson, TX 75082-2832

Mailing address

4112 E Renner Rd
Richardson, TX 75082-2832
Phone (972) 536-3972

National Provider Directory

National Provider Directory

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": "1538438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1538438400000",
    "number": "1295210573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4112 E RENNER RD",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750822832",
            "telephone_number": "972-536-3972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4112 E RENNER RD",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750822832",
            "telephone_number": "972-536-3972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONE STAR DENTAL ANESTHESIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-02",
        "last_updated": "2018-10-02",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "JINSOO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "972-536-3972",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223D0004X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Dental Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richardson, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 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.