NPIMap

Individual provider Active NPI

Dustin Sean Janssen, D.D.S.

  • Pediatric Dentistry
  • Lubbock, TX
National Provider Identifier
1447486485
Registry record updated Oct 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
24601 Issued in TX
Practice address
7515 Quaker Ave
Suite 100
Lubbock, TX 79424-5308
Phone
(806) 796-2408
Fax
(806) 686-6246
NPI assigned
Jun 4, 2009
Last updated
Oct 15, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 24601 TX Primary
Pediatric Dentistry 1223P0221X DD3138 NM

Addresses

Primary practice location

7515 Quaker Ave
Suite 100
Lubbock, TX 79424-5308

Mailing address

7515 Quaker Ave
Suite 100
Lubbock, TX 79424-5308
Phone (806) 796-2408

Other identifiers 3

IdentifierTypeStateIssuer
3196933MedicaidTX
319692501MedicaidTX
319692502MedicaidTX

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
DD3138NMMDPediatric Dentist
24601TXMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Parkview Pediatric Dental Holdings, PLLC Pediatric Dentistry Current Accepting new patients
Parkview Pediatric Dentistry, PLLC Pediatric Dentistry Current Accepting new patients

Locations

7515 Quaker Ave
Ste 100
Lubbock, TX 79424
Phone (806) 796-2408

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1244073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444867200000",
    "number": "1447486485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7515 QUAKER AVE",
            "address_2": "SUITE 100",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794245308",
            "telephone_number": "806-796-2408",
            "fax_number": "806-686-6246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7515 QUAKER AVE",
            "address_2": "SUITE 100",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794245308",
            "telephone_number": "806-796-2408",
            "fax_number": "806-686-6246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANSSEN",
        "first_name": "DUSTIN",
        "middle_name": "SEAN",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-04",
        "last_updated": "2015-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TX",
            "license": "24601",
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NM",
            "license": "DD3138",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3196933",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "319692501",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "319692502",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2015; 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.