NPIMap

Organization Active NPI

Central Austin Pediatric Dental, PLLC

  • Pediatric Dentistry
  • Austin, TX
National Provider Identifier
1437437639
Registry record updated Dec 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
24217 Issued in TX
Legal business name
CENTRAL AUSTIN PEDIATRIC DENTAL, PLLC
Practice address
1015 West 34TH St.
Austin, TX 78705
Phone
(512) 206-2929
Fax
(512) 206-2920
NPI assigned
Jul 22, 2011
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 DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X 24217 TX Primary

Addresses

Primary practice location

1015 West 34TH St.
Austin, TX 78705

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": "1311292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1483056000000",
    "number": "1437437639",
    "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": "1015 WEST 34TH ST.",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78705",
            "telephone_number": "512-206-2929",
            "fax_number": "512-206-2920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL AUSTIN PEDIATRIC DENTAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-22",
        "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": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TX",
            "license": "24217",
            "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.