NPIMap

Organization Active NPI

Jeffery Gerhardt DDS PC Dentistry

  • General Practice Dentistry
  • Cedar Park, TX
National Provider Identifier
1720187131
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
16831 Issued in TX
Legal business name
JEFFERY GERHARDT DDS PC DENTISTRY
Practice address
3415A El Salido Pkwy
Cedar Park, TX 78613-5521
Phone
(512) 257-2483
Fax
(512) 249-1057
NPI assigned
Sep 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Jeffery Wayne Gerhardt, DDSNPI 1487744207
Title
President
Phone
(512) 257-2483

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 16831 TX Primary

Addresses

Primary practice location

3415A El Salido Pkwy
Cedar Park, TX 78613-5521

Mailing address

3415A El Salido Pkwy
Cedar Park, TX 78613-5521
Phone (512) 257-2483

Other names 1

  • Advanced Family Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

3415 El Salido Pkwy
Ste A
Cedar Park, TX 78613
Phone (512) 257-2483

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1720187131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3415A EL SALIDO PKWY",
            "city": "CEDAR PARK",
            "state": "TX",
            "postal_code": "786135521",
            "telephone_number": "512-257-2483",
            "fax_number": "512-249-1057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3415A EL SALIDO PKWY",
            "city": "CEDAR PARK",
            "state": "TX",
            "postal_code": "786135521",
            "telephone_number": "512-257-2483",
            "fax_number": "512-249-1057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFERY GERHARDT DDS PC DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GERHARDT",
        "authorized_official_first_name": "JEFFERY",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "512-257-2483",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "16831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cedar Park, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.