Jeremy Kip Nielson, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

25461 Issued in TX

Practice address

10123 Lake Creek Pkwy
Building 2
Austin, TX 78729-1756

Phone

(512) 250-8101

Fax

(512) 258-7154

NPI assigned

Jun 4, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Kip Nielson Other name

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• J. Kip Nielson DDS PLLC

  dba Starlight Dental and Orthodontics

  • Dentist
  • Austin, TX
  • NPI 1558742593
  NPD (past)

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

{
    "created_epoch": "1275609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788220800000",
    "number": "1427378108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10123 LAKE CREEK PKWY BLDG 2",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787291756",
            "telephone_number": "512-250-8101",
            "fax_number": "512-258-7154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10123 LAKE CREEK PKWY",
            "address_2": "BUILDING 2",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787291756",
            "telephone_number": "512-250-8101",
            "fax_number": "512-258-7154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIELSON",
        "first_name": "JEREMY",
        "middle_name": "KIP",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-04",
        "last_updated": "2026-09-01",
        "certification_date": "2026-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "25461",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIP",
            "last_name": "NIELSON",
            "prefix": "DR.",
            "credential": "D.D.S.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Joy Nielsen, M.D.
• Kristian Thomas Nielsen, CRNA
• Mariann Nielsen, WHNP-C
• Sarah Nielsen, NBC-HWC
• Jed Cody Nielson, DDS
• Yen Dang Nieman, M.D.
• Nienke Splint Gul, Pmhnp, PLLC
• Juan Nieto, MD
• Kirsten Gibbs Nieto, M.D.
• Mario Edmundo Nieto, M.D.

• General Practice Dentistry in Austin, TX
• Providers in Austin, 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 Sep 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.