Texas Periodontists PC

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

Legal business name

TEXAS PERIODONTISTS PC

Practice address

12319 N Mopac Expy Ste 160
Austin, TX 78758-2648

Phone

(512) 222-5721

Fax

(512) 309-5273

NPI assigned

Jul 19, 2023

Last updated

Aug 1, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Melissa Dixon

Title

Manager

Phone

(512) 222-5721

Specialties & licenses 1

Addresses

Locations

Practitioners 3

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.

• Sreevidya Bodapati, D.D.S., M.S.

  • Periodontics
  • Austin, TX
  • NPI 1851582415
  NPD
• Siddharth Gupta, BDS,MS

  • Periodontics
  • Austin, TX
  • NPI 1013163260
  NPD
• Shiyamali Sundararajan

  • Periodontics
  • Austin, TX
  • NPI 1679254544
  NPD

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

{
    "created_epoch": "1689724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690848000000",
    "number": "1467132159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12319 N MOPAC EXPY STE 160",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787582648",
            "telephone_number": "512-222-5721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12319 N MOPAC EXPY STE 160",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787582648",
            "telephone_number": "512-222-5721",
            "fax_number": "512-309-5273"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8701 Menchaca Rd. Building #3, Suite #103",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "78748",
            "country_code": "US",
            "telephone_number": "512-222-5724",
            "fax_number": "512-309-5273",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TEXAS PERIODONTISTS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-19",
        "last_updated": "2023-08-01",
        "certification_date": "2023-08-01",
        "status": "A",
        "authorized_official_last_name": "DIXON",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "512-222-5721"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Texas Pain Center ASC
• Texas Palliative Services PA
• Texas Performance Health PLLC (Upper Extremity ATX)
• Texas Personal Injury Medical Center LLC
• Texas PHS Professional Association
• Texas Physical Therapy Specialists
• Texas Physical Therapy Specialists
• Texas Physical Therapy Specialists

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 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.