Active NPI
Jacquelyn Wallace Morris, DDS
- Dentist
- Austin, TX
National Provider Identifier
1639259682
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 20423
- Practice address
- 9000 Anderson Mill Rd
Austin, TX 78729 - Phone
- (512) 331-9088
- Fax
- (512) 918-9017
- NPI assigned
- Oct 16, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 20423 | TX | Primary |
Addresses
Primary practice location
9000 Anderson Mill Rd
Austin, TX 78729
Mailing address
2504 Lake Austin Blvd
Austin, TX 78703
Phone (512) 474-5233
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20423 | TX | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lake Austin Family Dental, PLLC | Past | Accepting new patients | |
| Balcones Family Dental | Dentist | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Dentist
- Austin, TX
- NPI 1710098439
-
- Dental Clinic/Center
- Austin, TX
- NPI 1144557497
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160956800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1259625600000",
"number": "1639259682",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2504 LAKE AUSTIN BLVD",
"city": "AUSTIN",
"state": "TX",
"postal_code": "78703",
"telephone_number": "512-474-5233"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9000 ANDERSON MILL RD",
"city": "AUSTIN",
"state": "TX",
"postal_code": "78729",
"telephone_number": "512-331-9088",
"fax_number": "512-918-9017"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORRIS",
"first_name": "JACQUELYN",
"middle_name": "WALLACE",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-16",
"last_updated": "2009-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "20423",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.