Jessica Brooke Wharton, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

35946 Issued in TX

Practice address

581 University Blvd #400
Round Rock, TX 78665

Phone

(512) 244-3333

Fax

(512) 341-0631

NPI assigned

Jun 20, 2018

Last updated

Aug 14, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Tphan Dental PLLC

  dba Moment Dental

  • Dentist
  • Round Rock, TX
  • NPI 1891453718
  NPD

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

{
    "created_epoch": "1529452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691971200000",
    "number": "1710471941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "581 UNIVERSITY BLVD #400",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "78665",
            "telephone_number": "512-244-3333",
            "fax_number": "512-341-0631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "581 UNIVERSITY BLVD #400",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "78665",
            "telephone_number": "512-244-3333",
            "fax_number": "512-341-0631"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Continental Dr",
            "address_purpose": "LOCATION",
            "city": "Elizabethtown",
            "state": "PA",
            "postal_code": "170222260",
            "country_code": "US",
            "telephone_number": "717-376-1336",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHARTON",
        "first_name": "JESSICA",
        "middle_name": "BROOKE",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-20",
        "last_updated": "2023-08-14",
        "certification_date": "2021-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS041745",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "35946",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "454338101",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@smilehausmedicalpkwy.com",
            "affiliation": "N",
            "address_1": "4203 Medical Pkwy",
            "city": "Austin",
            "state": "TX",
            "country_code": "US",
            "postal_code": "787563309",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• General Practice Dentistry in Round Rock, TX
• Providers in Round Rock, 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 Aug 14, 2023; 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.