Individual provider Active NPI

Lara Alexandra Perry, D.D.S.

  • General Practice Dentistry
  • New Braunfels, TX
National Provider Identifier
1790822500
Registry record updated Nov 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
22207 Issued in TX
Practice address
1929 W State Highway 46 Ste 102
New Braunfels, TX 78132-5337
Phone
(830) 460-3400
Fax
(830) 584-0500
NPI assigned
Jan 31, 2007
Last updated
Nov 17, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 22207 TX Primary

Addresses

Primary practice location

1929 W State Highway 46 Ste 102
New Braunfels, TX 78132-5337

Mailing address

81 Mission Dr
New Braunfels, TX 78130-6668
Phone (830) 730-6606

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Nov 1, 2021 through Nov 1, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
22207TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Lara a Perry DDS PA General Practice Current Accepting new patients
Lara a Perry DDS PA General Practice Current Accepting new patients
Lara a Perry DDS PA CurrentSince Nov 22, 2020 Accepting new patients

Locations

1929 State Highway 46 W
Ste 102
New Braunfels, TX 78132
Phone (830) 460-3400

317 S State Highway 46
Seguin, TX 78155
Phone (830) 379-8902

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605571200000",
    "number": "1790822500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "81 MISSION DR",
            "city": "NEW BRAUNFELS",
            "state": "TX",
            "postal_code": "781306668",
            "telephone_number": "830-730-6606",
            "fax_number": "830-379-9280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1929 W STATE HIGHWAY 46 STE 102",
            "city": "NEW BRAUNFELS",
            "state": "TX",
            "postal_code": "781325337",
            "telephone_number": "830-460-3400",
            "fax_number": "830-584-0500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRY",
        "first_name": "LARA",
        "middle_name": "ALEXANDRA",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-31",
        "last_updated": "2020-11-17",
        "certification_date": "2020-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "22207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Braunfels, TX

Sources for this page

Verify at the official NPI Registry.