NPIMap

Organization Active NPI

Brush32 Dental of Georgetown PLLC

Doing business as Ideal Dental Georgetown

  • Dentist
  • Georgetown, TX
National Provider Identifier
1427522796
Registry record updated Oct 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
BRUSH32 DENTAL OF GEORGETOWN PLLC
Doing business as
Ideal Dental Georgetown
Practice address
1431 S Interstate 35 Ste 105
Georgetown, TX 78626-5427
Phone
(512) 758-8634
Fax
(512) 462-3233
NPI assigned
Jan 19, 2019
Last updated
Oct 2, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2023

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

Authorized official

Name
Rodney Alles, DDS
Title
Owner
Phone
(972) 331-8079

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

1431 S Interstate 35 Ste 105
Georgetown, TX 78626-5427

Mailing address

PO Box 840925
Dallas, TX 75284-0925

Other names 1

  • Ideal Dental Georgetown Doing business as

National Provider Directory

National Provider Directory

Locations

1431 S Interstate 35
Ste 105
Georgetown, TX 78626
Phone (512) 758-8634

Practitioners & affiliated clinicians

Practitioners 4

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": "1547856000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696204800000",
    "number": "1427522796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 840925",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752840925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1431 S INTERSTATE 35 STE 105",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786265427",
            "telephone_number": "512-758-8634",
            "fax_number": "512-462-3233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRUSH32 DENTAL OF GEORGETOWN PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-19",
        "last_updated": "2023-10-02",
        "certification_date": "2023-10-02",
        "status": "A",
        "authorized_official_last_name": "ALLES",
        "authorized_official_first_name": "RODNEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "972-331-8079",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ideal Dental Georgetown",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Georgetown, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2023; 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.