NPIMap

Organization Active NPI

Stassney Smiles, P.C.

  • General Practice Dentistry
  • Austin, TX
National Provider Identifier
1801218854
Registry record updated Jan 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
23496 Issued in TX
Legal business name
STASSNEY SMILES, P.C.
Doing business as
River Rock Dental - Stassney
Practice address
5717 South Ih 35
BLDG B Suite #101
Austin, TX 78744
Phone
(512) 462-4775
Fax
(512) 462-4782
NPI assigned
Jan 10, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2014

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

Authorized official

Name
Dr. Jackson Booth, DDS
Title
Owner
Phone
(512) 739-9440

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 23496 TX Primary

Addresses

Primary practice location

5717 South Ih 35
BLDG B Suite #101
Austin, TX 78744

Mailing address

4410 E Riverside Dr
Suite 150
Austin, TX 78741-4799
Phone (512) 206-4484

Other names 1

  • River Rock Dental - Stassney Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1389312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389312000000",
    "number": "1801218854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4410 E RIVERSIDE DR",
            "address_2": "SUITE 150",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787414799",
            "telephone_number": "512-206-4484",
            "fax_number": "512-206-4993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5717 SOUTH IH 35",
            "address_2": "BLDG B SUITE #101",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78744",
            "telephone_number": "512-462-4775",
            "fax_number": "512-462-4782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STASSNEY SMILES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-10",
        "last_updated": "2014-01-10",
        "status": "A",
        "authorized_official_last_name": "BOOTH",
        "authorized_official_first_name": "JACKSON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "512-739-9440",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "23496",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "River Rock Dental - Stassney",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2014; 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.