Round Rock Modern Dentistry, PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

ROUND ROCK MODERN DENTISTRY, PC

Doing business as

Round Rock Modern Dentistry

Practice address

2150 E Palm Valley Blvd
Suite 500
Round Rock, TX 78665-1529

Phone

(512) 218-1900

Fax

(512) 218-1901

NPI assigned

Nov 10, 2014

Last updated

Nov 10, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. John S Barnes, DDS

Title

Owner

Phone

(512) 218-1900

Specialties & licenses 1

Addresses

Other names 1

• Round Rock Modern Dentistry Doing business as

Locations

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.

• Ellen Betty Cainsford, DDS

  • General Practice Dentistry
  • Austin, TX
  • NPI 1265131338
  NPD (past)

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

{
    "created_epoch": "1415577600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415577600000",
    "number": "1346646981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17000 RED HILL AVE",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926145626",
            "telephone_number": "714-845-8890",
            "fax_number": "949-474-1495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2150 E PALM VALLEY BLVD",
            "address_2": "SUITE 500",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786651529",
            "telephone_number": "512-218-1900",
            "fax_number": "512-218-1901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROUND ROCK MODERN DENTISTRY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-10",
        "last_updated": "2014-11-10",
        "status": "A",
        "authorized_official_last_name": "BARNES",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "512-218-1900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Round Rock Modern Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Round Rock Rehab, PC
• Round Rock SCC LLC (Trinity Care Center)
• Round Rock SNF Operations LLC (San Gabriel Rehabilitation and Care Center)

• General Practice Dentistry in Round Rock, TX
• Providers in Round Rock, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2014; 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.