Laresea Woods, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

33259 Issued in TX

Practice address

1620 Grand Avenue Pkwy Ste 130
Pflugerville, TX 78660-2185

Phone

(512) 670-8482

Fax

(512) 215-8154

NPI assigned

Aug 12, 2010

Last updated

Apr 12, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Conglomerate PLLC

  dba The Grand Family Dental

  • Dentist
  • Pflugerville, TX
  • NPI 1154955805
  Authorized official Same address or phone

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

{
    "created_epoch": "1281571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712880000000",
    "number": "1568777654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2721 MONTE RANCH TRL",
            "city": "LEANDER",
            "state": "TX",
            "postal_code": "786414371",
            "telephone_number": "334-590-4223",
            "fax_number": "870-642-7655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 GRAND AVENUE PKWY STE 130",
            "city": "PFLUGERVILLE",
            "state": "TX",
            "postal_code": "786602185",
            "telephone_number": "512-670-8482",
            "fax_number": "512-215-8154"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "110 W Dequeen Ave",
            "address_purpose": "LOCATION",
            "city": "DE Queen",
            "state": "AR",
            "postal_code": "718322808",
            "country_code": "US",
            "telephone_number": "870-642-7645",
            "fax_number": "870-642-7655",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOODS",
        "first_name": "LARESEA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-12",
        "last_updated": "2024-04-12",
        "certification_date": "2021-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AR",
            "license": "3787",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "33259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Wojciechowski
• Amanda Woltering
• Jennifer Rose Womack, LPC-A
• Bailey Madeleine Wood
• Amy Michelle Woods, L.AC.
• Sabreen Woolfolk, SLP-INTERN
• Jennifer Wostarek
• Melissa Lorraine Wren, LPC
• Wright Counseling, PLLC
• Candice Jeanette Wright, LPC

• General Practice Dentistry in Pflugerville, TX
• Providers in Pflugerville, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.