Individual provider Active NPI

Michael R. Augustine Jr., DDS

  • General Practice Dentistry
  • Austin, TX
National Provider Identifier
1427124064
Registry record updated Dec 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
20518 Issued in TX
Practice address
12505 Hymeadow Dr
Suite 2D
Austin, TX 78750-1867
Phone
(512) 258-3627
Fax
(512) 258-0755
NPI assigned
Nov 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 18, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 20518 TX Primary

Addresses

Primary practice location

12505 Hymeadow Dr
Suite 2D
Austin, TX 78750-1867

Mailing address

12505 Hymeadow Dr
Suite 2D
Austin, TX 78750-1867
Phone (512) 258-3627

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
20518TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
George M. Blackburn Jr. D.M.D. Past Accepting new patients
Levo Dental 10 PLLC General Practice Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1164585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418860800000",
    "number": "1427124064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12505 HYMEADOW DR",
            "address_2": "SUITE 2D",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787501867",
            "telephone_number": "512-258-3627",
            "fax_number": "512-258-0755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12505 HYMEADOW DR",
            "address_2": "SUITE 2D",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787501867",
            "telephone_number": "512-258-3627",
            "fax_number": "512-258-0755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AUGUSTINE",
        "first_name": "MICHAEL",
        "middle_name": "R.",
        "name_suffix": "Jr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-27",
        "last_updated": "2014-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "20518",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 18, 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.