Sofia Luque, DDS, PLLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

24159 Issued in TX

Legal business name

SOFIA LUQUE, DDS, PLLC

Practice address

2500 W William Cannon Dr
Austin, TX 78745-5257

Phone

(512) 662-1455

NPI assigned

Dec 5, 2011

Organization subpart

No

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

Authorized official

Name

Sofia Luque

Title

Owner

Phone

(512) 965-3355

Specialties & licenses 1

Addresses

Other names 1

• Dentalsaurus Doing business as

Locations

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

{
    "created_epoch": "1323043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323043200000",
    "number": "1679841613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11109 COMISO PALA PATH",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787262409",
            "telephone_number": "512-965-3355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 W WILLIAM CANNON DR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787455257",
            "telephone_number": "512-662-1455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOFIA LUQUE, DDS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-05",
        "last_updated": "2011-12-05",
        "status": "A",
        "authorized_official_last_name": "LUQUE",
        "authorized_official_first_name": "SOFIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "512-965-3355"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TX",
            "license": "24159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dentalsaurus",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• 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 Dec 5, 2011; 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.