NPIMap

Organization Active NPI

Affordable Dentures & Implants - Texas, PLLC

  • General Practice Dentistry
  • Georgetown, TX
National Provider Identifier
1750616637
Registry record updated Nov 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
AFFORDABLE DENTURES & IMPLANTS - TEXAS, PLLC
Practice address
1103 Rivery Blvd
Ste 300
Georgetown, TX 78628-3034
Phone
(918) 473-0285
NPI assigned
Oct 9, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2021

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

Authorized official

Name
Haley Wooster
Title
Enrollment Specialist
Phone
(712) 733-8551

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 0021124 TX
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

1103 Rivery Blvd
Ste 300
Georgetown, TX 78628-3034

Mailing address

1103 Rivery Blvd
Ste 300
Georgetown, TX 78628-3034

National Provider Directory

National Provider Directory
Tax ID family
Affordable Dentures Implants - Texas PLLC42 organizations share this tax ID, including this one

Other organizations with this tax ID 41

Organizations that report the same tax identification number in the National Provider Directory.

View all 41

Locations

1103 Rivery Blvd
Ste 300
Georgetown, TX 78628
Phone (512) 868-0238

Practitioners & affiliated clinicians

Practitioners 1

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": "1255046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637107200000",
    "number": "1750616637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1103 RIVERY BLVD",
            "address_2": "STE 300",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786283034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1103 RIVERY BLVD",
            "address_2": "STE 300",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786283034",
            "telephone_number": "918-473-0285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AFFORDABLE DENTURES & IMPLANTS - TEXAS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-09",
        "last_updated": "2021-11-17",
        "certification_date": "2021-11-17",
        "status": "A",
        "authorized_official_last_name": "WOOSTER",
        "authorized_official_first_name": "HALEY",
        "authorized_official_title_or_position": "ENROLLMENT SPECIALIST",
        "authorized_official_telephone_number": "712-733-8551"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "TX",
            "license": "0021124",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Georgetown, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2021; 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.