NPIMap

Organization Active NPI

Lakeway Pediatric Dental, PLLC

Doing business as Lone Star Pediatric Dental

  • Pediatric Dentistry
  • Austin, TX
National Provider Identifier
1346539996
Registry record updated Dec 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
LAKEWAY PEDIATRIC DENTAL, PLLC
Doing business as
Lone Star Pediatric Dental
Practice address
14058 Bee Caves Pkwy
BLDG. D. Suite B
Austin, TX 78738
Phone
(512) 402-9996
Fax
(512) 402-9986
NPI assigned
Apr 5, 2011
Last updated
Dec 30, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2016

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

Authorized official

Name
Dr. Marty Montgomery, DMD
Title
Owner
Phone
(512) 206-2975

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X NU Primary

Addresses

Primary practice location

14058 Bee Caves Pkwy
BLDG. D. Suite B
Austin, TX 78738

Mailing address

505 E Huntland Dr.
#340
Austin, TX 78752
Phone (512) 206-2975

Other names 1

  • Lone Star Pediatric Dental Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Central Austin Pediatric Dental PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1301961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1483056000000",
    "number": "1346539996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 E HUNTLAND DR.",
            "address_2": "#340",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78752",
            "telephone_number": "512-206-2975",
            "fax_number": "512-371-8779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14058 BEE CAVES PKWY",
            "address_2": "BLDG. D. SUITE B",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78738",
            "telephone_number": "512-402-9996",
            "fax_number": "512-402-9986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKEWAY PEDIATRIC DENTAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-05",
        "last_updated": "2016-12-30",
        "status": "A",
        "authorized_official_last_name": "MONTGOMERY",
        "authorized_official_first_name": "MARTY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "512-206-2975",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lone Star Pediatric Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2016; 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.