Individual provider Active NPI

George Arthur Tanksley Jr., DMD

  • Dentist
  • Austin, TX
National Provider Identifier
1760442909
Registry record updated Oct 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
23816 Issued in TX
Practice address
10710 Research Blvd
Suite 302
Austin, TX 78759-5798
Phone
(512) 568-3500
Fax
(512) 372-4528
NPI assigned
Mar 23, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 2, 2010

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 4619T NV
General Practice Dentistry 1223G0001X 22DI02044900 NJ
Dentist 122300000X 23816 TX Primary

Addresses

Primary practice location

10710 Research Blvd
Suite 302
Austin, TX 78759-5798

Mailing address

1218 SW Military Dr
San Antonio, TX 78221-1535
Phone (210) 928-2814

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150731016285 CA Order and Referring Only - DentistPractitioner - Dentist 5799099982

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22DI02044900NJMDGeneral Practice Dentistry
4619TNVMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285977600000",
    "number": "1760442909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1218 SW MILITARY DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782211535",
            "telephone_number": "210-928-2814",
            "fax_number": "210-928-2364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10710 RESEARCH BLVD",
            "address_2": "SUITE 302",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787595798",
            "telephone_number": "512-568-3500",
            "fax_number": "512-372-4528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANKSLEY",
        "first_name": "GEORGE",
        "middle_name": "ARTHUR",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-23",
        "last_updated": "2010-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NV",
            "license": "4619T",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DI02044900",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "23816",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.