Anderson Lane Dental Center PLLC

Primary specialty

DentistTaxonomy code 122300000X

License

28268 Issued in TX

Legal business name

ANDERSON LANE DENTAL CENTER PLLC

Doing business as

Anderson Lane Dental

Practice address

1802 W Anderson LN
Austin, TX 78757-1338

Phone

(512) 459-4347

Fax

(512) 459-4348

NPI assigned

Jan 2, 2014

Organization subpart

No

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

Authorized official

Name

Mr. Gerald Bernard Pevow, DMD

Title

Owner

Phone

(512) 459-4347

Specialties & licenses 1

Addresses

Other names 1

• ANDERSON LANE DENTAL Doing business as

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

{
    "created_epoch": "1388620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1388620800000",
    "number": "1457772816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1802 W ANDERSON LN",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787571338",
            "telephone_number": "512-459-4347",
            "fax_number": "512-459-4348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1802 W ANDERSON LN",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787571338",
            "telephone_number": "512-459-4347",
            "fax_number": "512-459-4348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDERSON LANE DENTAL CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-02",
        "last_updated": "2014-01-02",
        "status": "A",
        "authorized_official_last_name": "PEVOW",
        "authorized_official_first_name": "GERALD",
        "authorized_official_middle_name": "BERNARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "512-459-4347",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "TX",
            "license": "28268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ANDERSON LANE DENTAL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Amy Anderson Cunningham, M.S., CCC/SLP
• Shawna R Anderson Curry
• Jillian Anderson Galligher, RD,CNSC,LD
• Laura Brooke Anderson Kramer, RD
• Anderson Lane Dental
• Anderson Lane Vision Source LLC
• Anderson Mill Austin Emergency Center LLC
• Amy P Anderson-Dueber, LPC
• Allison Leigh Anderson, MD
• Amber Anderson, PT

• Dentist in Austin, TX
• Providers in Austin, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2014; 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.