NPIMap

Organization Active NPI

Dental Health Associates of Texas, PC

Doing business as South Austin Dentist

  • General Practice Dentistry
  • Austin, TX
National Provider Identifier
1639664246
Registry record updated Jun 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
DENTAL HEALTH ASSOCIATES OF TEXAS, PC
Doing business as
South Austin Dentist
Practice address
3901 S Lamar Blvd Ste 480
Austin, TX 78704-7990
Phone
(512) 448-3131
NPI assigned
Jun 26, 2018
Last updated
Jun 26, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
DENTAL HEALTH ASSOCIATES OF TEXAS, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 26, 2018

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

Authorized official

Name
Cassandra Petersen
Title
Credentialing Team Lead
Phone
(217) 540-8972

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

3901 S Lamar Blvd Ste 480
Austin, TX 78704-7990

Mailing address

3901 S Lamar Blvd Ste 480
Austin, TX 78704-7990
Phone (512) 448-3131

Other names 1

  • South Austin Dentist Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dental Health Associates of Texas PC149 organizations share this tax ID, including this one
Part of
Dental Health Associates of Texas PC

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

3901 S Lamar Blvd
Ste 480
Austin, TX 78704
Phone (512) 448-3131

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1529971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529971200000",
    "number": "1639664246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3901 S LAMAR BLVD STE 480",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787047990",
            "telephone_number": "512-448-3131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 S LAMAR BLVD STE 480",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787047990",
            "telephone_number": "512-448-3131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL HEALTH ASSOCIATES OF TEXAS, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DENTAL HEALTH ASSOCIATES OF TEXAS, PC",
        "enumeration_date": "2018-06-26",
        "last_updated": "2018-06-26",
        "status": "A",
        "authorized_official_last_name": "PETERSEN",
        "authorized_official_first_name": "CASSANDRA",
        "authorized_official_title_or_position": "CREDENTIALING TEAM LEAD",
        "authorized_official_telephone_number": "217-540-8972"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Austin Dentist",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jun 26, 2018; 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.