Individual provider Active NPI

Elizabeth Irma Scott, DDS

  • Pediatric Dentistry
  • Belton, TX
National Provider Identifier
1811475643
Registry record updated Jun 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
34503 Issued in TX
Practice address
412 Lake Rd
Belton, TX 76513
Phone
(254) 791-5147
NPI assigned
Aug 3, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 34503 TX
Pediatric Dentistry 1223P0221X 34503 TX Primary

Addresses

Primary practice location

412 Lake Rd
Belton, TX 76513

Mailing address

505 E Huntland Dr Ste 340
Austin, TX 78752-3745

Other practice location 1

169 Ashley Avenue
Room 202 Main Hospital, MSC 333
Charleston, SC 29425
Phone (843) 792-3916

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20181212003449 SC Order and Referring Only - DentistPractitioner - Dentist 0749525160

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34503TXMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1533254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593388800000",
    "number": "1811475643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 E HUNTLAND DR STE 340",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787523745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 LAKE RD",
            "city": "BELTON",
            "state": "TX",
            "postal_code": "76513",
            "telephone_number": "254-791-5147"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "169 Ashley Avenue",
            "address_2": "Room 202 Main Hospital, MSC 333",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "SC",
            "postal_code": "29425",
            "country_code": "US",
            "telephone_number": "843-792-3916",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCOTT",
        "first_name": "ELIZABETH",
        "middle_name": "IRMA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-03",
        "last_updated": "2020-06-29",
        "certification_date": "2020-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "34503",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TX",
            "license": "34503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belton, TX

Sources for this page

Verify at the official NPI Registry.