NPIMap

Organization Active NPI

Lago Vista Family Dentistry, Inc.

  • Pediatric Dentistry
  • Lago Vista, TX
National Provider Identifier
1871923284
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
10843 Issued in TX
Legal business name
LAGO VISTA FAMILY DENTISTRY, INC.
Doing business as
Red Balloon Family Dentistry-Lago Vista
Practice address
8008 Bronco Lane
Suite B
Lago Vista, TX 78645
Phone
(512) 277-3311
Fax
(512) 727-7943
NPI assigned
Nov 21, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Dr. Taran Bhatia, DMD
Title
Owner/President
Phone
(512) 817-4940

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X 10843 TX Primary

Addresses

Primary practice location

8008 Bronco Lane
Suite B
Lago Vista, TX 78645

Mailing address

1907 S. US-183
Suite 206
Leander, TX 78641
Phone (512) 817-4940

Other names 1

  • Red Balloon Family Dentistry-Lago Vista Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1384992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1871923284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1907 S. US-183",
            "address_2": "SUITE 206",
            "city": "LEANDER",
            "state": "TX",
            "postal_code": "78641",
            "telephone_number": "512-817-4940",
            "fax_number": "512-817-4955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8008 BRONCO LANE",
            "address_2": "SUITE B",
            "city": "LAGO VISTA",
            "state": "TX",
            "postal_code": "78645",
            "telephone_number": "512-277-3311",
            "fax_number": "512-727-7943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAGO VISTA FAMILY DENTISTRY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-21",
        "last_updated": "2022-07-21",
        "certification_date": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "BHATIA",
        "authorized_official_first_name": "TARAN",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "512-817-4940",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TX",
            "license": "10843",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Red Balloon Family Dentistry-Lago Vista",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lago Vista, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.