NPIMap

Organization Active NPI

Austin Dental Group PLLC

Doing business as 04 Dental

  • General Practice Dentistry
  • Austin, TX
National Provider Identifier
1801373782
Registry record updated Jul 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
AUSTIN DENTAL GROUP PLLC
Doing business as
04 Dental
Practice address
3115 S Lamar Blvd
Austin, TX 78704-5803
Phone
(512) 640-4090
Fax
(512) 386-1142
NPI assigned
Jul 24, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2018

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

Authorized official

Name
Steven Cook, DDSNPI 1467469098
Title
Owner
Phone
(512) 451-8256

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

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

Addresses

Primary practice location

3115 S Lamar Blvd
Austin, TX 78704-5803

Mailing address

1901 Barton Hills Dr
Austin, TX 78704-3217
Phone (512) 640-4090

Other names 1

  • 04 Dental Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1532390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1532390400000",
    "number": "1801373782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 BARTON HILLS DR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787043217",
            "telephone_number": "512-640-4090",
            "fax_number": "512-386-1142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3115 S LAMAR BLVD",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787045803",
            "telephone_number": "512-640-4090",
            "fax_number": "512-386-1142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUSTIN DENTAL GROUP PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-24",
        "last_updated": "2018-07-24",
        "status": "A",
        "authorized_official_last_name": "COOK",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "512-451-8256",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "04 Dental",
            "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 Jul 24, 2018; 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.