Banyan Tree Dental, P.a.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

19143 Issued in TX

Legal business name

BANYAN TREE DENTAL, P.A.

Practice address

11416 FM 620 Ste N
Suite K
Austin, TX 78726-1165

Phone

(512) 382-7123

NPI assigned

Apr 3, 2013

Last updated

Apr 3, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Michelle Truong, D.D.S.NPI 1740485184

Title

President

Phone

(512) 382-7123

Specialties & licenses 1

Addresses

Locations

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.

• Michelle Truong, D.D.S.

  • General Practice Dentistry
  • Austin, TX
  • NPI 1740485184
  NPD (past) Authorized official

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

{
    "created_epoch": "1364947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364947200000",
    "number": "1689917106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11416 FM 620 STE N",
            "address_2": "SUITE K",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787261165",
            "telephone_number": "512-382-7123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11416 FM 620 STE N",
            "address_2": "SUITE K",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787261165",
            "telephone_number": "512-382-7123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BANYAN TREE DENTAL, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-03",
        "last_updated": "2013-04-03",
        "status": "A",
        "authorized_official_last_name": "TRUONG",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "512-382-7123",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "19143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William J. Banks, MD
• Amy S Bannerman, MA, CCC/A
• Puja Bansal
• Zanni Bantam
• Ronald Guillermo Banuelos, LAC
• Delong Bao, PHARM.D.
• Reginald Carl Baptiste, M.D.
• Hailey Barab
• Jeshua Jorge Barak, PA
• Joseph Robert Baranco, CRNA

• General Practice Dentistry in Austin, TX
• Providers in Austin, 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 3, 2013; 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.