Senior Smiles PA

Primary specialty

DentistTaxonomy code 122300000X

License

25128 Issued in TX

Legal business name

SENIOR SMILES PA

Practice address

2550 S Ih 35
Suite 215
Austin, TX 78704-5722

Phone

(512) 381-5572

Fax

(888) 503-5605

NPI assigned

Jan 29, 2015

Last updated

Jan 29, 2015By 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

Dr. Gregory Kon, DDS

Title

President & Owner

Phone

(512) 381-5572

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1422489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422489600000",
    "number": "1538559422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 41266",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787040022",
            "telephone_number": "512-381-5572",
            "fax_number": "888-503-5605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2550 S IH 35",
            "address_2": "SUITE 215",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787045722",
            "telephone_number": "512-381-5572",
            "fax_number": "888-503-5605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SENIOR SMILES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-29",
        "last_updated": "2015-01-29",
        "status": "A",
        "authorized_official_last_name": "KON",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_title_or_position": "PRESIDENT & OWNER",
        "authorized_official_telephone_number": "512-381-5572",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "25128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• 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 29, 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.