Individual provider Active NPI

Justin Philip, DMD

  • Dentist
  • Lewisville, TX
National Provider Identifier
1699458182
Registry record updated Aug 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
41222 Issued in TX
Practice address
2702 Lake Vista Dr # 1
Lewisville, TX 75067-3802
Phone
(972) 248-1221
Fax
(972) 248-1072
NPI assigned
Aug 10, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 41222 TX Primary

Addresses

Primary practice location

2702 Lake Vista Dr # 1
Lewisville, TX 75067-3802

Mailing address

1261 Woodland View Rd
Lawrenceville, GA 30043-7513

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

LicenseStateTypeSpecialty
DN123234GAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Lewisville Family Dental PLLC PastSince Jan 2, 2022 Accepting new patients
Alpine Dental Group of Buckhead PastSince Aug 13, 2023 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.

NPI Registry JSON

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

{
    "created_epoch": "1691625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786492800000",
    "number": "1699458182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1261 WOODLAND VIEW RD",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300437513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2702 LAKE VISTA DR # 1",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "750673802",
            "telephone_number": "972-248-1221",
            "fax_number": "972-248-1072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILIP",
        "first_name": "JUSTIN",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-10",
        "last_updated": "2026-08-12",
        "certification_date": "2026-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "41222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewisville, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2026; 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.