Organization Active NPI

Bertram Dental, PLLC

  • Dental Clinic/Center
  • Bertram, TX
National Provider Identifier
1730968470
Registry record updated Sep 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
BERTRAM DENTAL, PLLC
Practice address
1220 W State Highway 29
Bertram, TX 78605-4022
Phone
(512) 355-2115
NPI assigned
Sep 22, 2023
Last updated
Sep 22, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2023

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

Authorized official

Name
Carla Thomas, DDSNPI 1730532094
Title
Owner
Phone
(903) 818-2690

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
Dental Clinic/Center 261QD0000X NU Primary

Addresses

Primary practice location

1220 W State Highway 29
Bertram, TX 78605-4022

Mailing address

1220 W State Highway 29
Bertram, TX 78605-4022
Phone (512) 355-2115

National Provider Directory

National Provider Directory

Locations

1220 W State Highway 29
Bertram, TX 78605
Phone (512) 355-2115

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1695340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695340800000",
    "number": "1730968470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 W STATE HIGHWAY 29",
            "city": "BERTRAM",
            "state": "TX",
            "postal_code": "786054022",
            "telephone_number": "512-355-2115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 W STATE HIGHWAY 29",
            "city": "BERTRAM",
            "state": "TX",
            "postal_code": "786054022",
            "telephone_number": "512-355-2115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BERTRAM DENTAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-22",
        "last_updated": "2023-09-22",
        "certification_date": "2023-09-22",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "CARLA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "903-818-2690",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bertram, TX

Sources for this page

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