Individual provider Active NPI

Vincent Anthony Morales, D.D.S.

  • General Practice Dentistry
  • Austin, TX
National Provider Identifier
1790010767
Registry record updated Jun 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
24035 Issued in TX
Practice address
6911 Ranch Road 620 N BLDG C-100
Austin, TX 78732-1825
Phone
(512) 249-5555
Fax
(512) 291-3771
NPI assigned
Oct 8, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 18, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 24035 TX
General Practice Dentistry 1223G0001X 24035 TX Primary

Addresses

Primary practice location

6911 Ranch Road 620 N BLDG C-100
Austin, TX 78732-1825

Mailing address

6911 Ranch Road 620 N C-100
Austin, TX 78732-1825
Phone (512) 249-5555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, TN2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160106001006 TX Order and Referring Only - DentistPractitioner - Dentist 6002118163
I20260526002539 TN Order and Referring Only - Emergency MedicinePractitioner - Emergency Medicine 6002118163

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1254960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560816000000",
    "number": "1790010767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6911 RANCH ROAD 620 N C-100",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787321825",
            "telephone_number": "512-249-5555",
            "fax_number": "512-291-3771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6911 RANCH ROAD 620 N BLDG C-100",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787321825",
            "telephone_number": "512-249-5555",
            "fax_number": "512-291-3771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORALES",
        "first_name": "VINCENT",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-10-08",
        "last_updated": "2019-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "24035",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "24035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.