Austin Central Park Pediatric Dentistry

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

28784 Issued in TX

Legal business name

AUSTIN CENTRAL PARK PEDIATRIC DENTISTRY

Doing business as

Central Park Pediatric Dentistry

Practice address

1005 W 38TH St Ste 200
Austin, TX 78705-1042

Phone

(512) 330-4624

NPI assigned

Apr 1, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Daniel Crandall Johnson, DDSNPI 1619250123

Title

Owner/Dentist

Phone

(512) 330-4624

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Central Park Pediatric Dentistry Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Daniel C Johnson, DDS

  • Pediatric Dentistry
  • Austin, TX
  • NPI 1619250123
  NPD Authorized official
• Patricia Robus, DDS

  • Pediatric Dentistry
  • Austin, TX
  • NPI 1083020523
  NPD (past)

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

{
    "created_epoch": "1396310400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729468800000",
    "number": "1639597222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 W 38TH ST STE 200",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787051042",
            "telephone_number": "512-330-4624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 W 38TH ST STE 200",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787051042",
            "telephone_number": "512-330-4624"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13341 W US 290",
            "address_2": "Building 1-106",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "78737",
            "country_code": "US",
            "telephone_number": "512-330-4624",
            "fax_number": "512-330-4653",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4308 N Quinlan Park Rd Ste 201",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787326071",
            "country_code": "US",
            "telephone_number": "512-330-4624",
            "fax_number": "512-583-4653",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "AUSTIN CENTRAL PARK PEDIATRIC DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-01",
        "last_updated": "2024-10-21",
        "certification_date": "2024-10-15",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "CRANDALL",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "512-330-4624",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TX",
            "license": "28784",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1619250123",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3194185-03",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Central Park Pediatric Dentistry",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Central Park Pediatric Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Austin Center for Clinical Research
• Austin Center for Endodontics, PLLC
• Austin Center for Outpatient Surgery LP (Northwest Hills Surgical Hospital)
• Austin Center for Psychological Care, PA
• Austin Center for Therapy and Assessment
• Austin Child Guidance Center
• Austin Children's Chest Associates II (Austin Children's Chest Associates)
• Austin Children's Chest Associates, PA
• Austin Children's Clinic, PA
• Austin Children's General Anesthesia Dentistry, PLLC

• Pediatric Dentistry in Austin, TX
• Providers in Austin, 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 21, 2024; 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.