Rock That Smile Pediatric Dentistry PLLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

ROCK THAT SMILE PEDIATRIC DENTISTRY PLLC

Practice address

14005 N. Hwy 183
#800
Austin, TX 78717

Phone

(512) 266-7200

Fax

(512) 583-0675

NPI assigned

Dec 11, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Jeffrey B Gregerson, D.M.D.NPI 1114238128

Title

Owner

Phone

(512) 266-7200

Specialties & licenses 1

Addresses

Other names 1

• Lakeline Rising Stars Pediatric Dentistry Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jeffrey Boyd Gregerson, D.M.D.

  • Pediatric Dentistry
  • Austin, TX
  • NPI 1114238128
  NPD Authorized official

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

{
    "created_epoch": "1355184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426550400000",
    "number": "1447595855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14005 N. HWY 183",
            "address_2": "# 800",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78717",
            "telephone_number": "512-266-7200",
            "fax_number": "512-583-0675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14005 N. HWY 183",
            "address_2": "#800",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78717",
            "telephone_number": "512-266-7200",
            "fax_number": "512-583-0675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROCK THAT SMILE PEDIATRIC DENTISTRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-11",
        "last_updated": "2015-03-17",
        "status": "A",
        "authorized_official_last_name": "GREGERSON",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "512-266-7200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lakeline Rising Stars Pediatric Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Julia M Rocha
• Lynette Rocha
• Sonia Yvette Rocha, PNP
• Aaron Rochlen, PHD
• Rock Springs, LLC
• Rockdale Blackhawk, LLC
• Rockdale Blackhawk, LLC
• Rocket Pharmacy, Inc.
• Rockrose Therapeutic Center, PLLC
• Becky Rockwell, L.C.S.W.

• Pediatric Dentistry in Austin, TX
• Providers in Austin, TX by specialty
• Pediatric Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 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.