Lakeside Childrens Dentistry

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

27068 Issued in TX

Legal business name

LAKESIDE CHILDRENS DENTISTRY

Practice address

103 US Highway 281
Marble Falls, TX 78654-5701

Phone

(830) 693-4770

Fax

(830) 693-4773

NPI assigned

Mar 15, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Andrew Moroni Heaton, D.D.S.

Title

Member

Phone

(254) 698-0641

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1458000000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667174400000",
    "number": "1528429792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 N US HIGHWAY 281",
            "city": "MARBLE FALLS",
            "state": "TX",
            "postal_code": "786545701",
            "telephone_number": "830-693-4770",
            "fax_number": "830-693-4773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 US HIGHWAY 281",
            "city": "MARBLE FALLS",
            "state": "TX",
            "postal_code": "786545701",
            "telephone_number": "830-693-4770",
            "fax_number": "830-693-4773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESIDE CHILDRENS DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-15",
        "last_updated": "2022-10-31",
        "certification_date": "2022-10-31",
        "status": "A",
        "authorized_official_last_name": "HEATON",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "MORONI",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "254-698-0641",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TX",
            "license": "27068",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stacey Koziel, IHP
• Kenneth Kraemer, MD
• Deborah Jo Krahl, MD
• Alicia Rose Kunkel, AUD
• Kristin Marie Kutac, P.A.-C.
• Ronald Jeremy Lambert, D.C.
• Lela Lankerani, D.O.
• Kellyn June Lappinga
• Laurence Robert Bower III
• Connie Sue Lavoie, D.C.

• Pediatric Dentistry in Marble Falls, TX
• Providers in Marble Falls, TX by specialty
• Pediatric Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2022; 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.