Central Texas Periodontics

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

20343 Issued in TX

Legal business name

CENTRAL TEXAS PERIODONTICS

Practice address

1811 N. Austin Ave.
Suite 101
Georgetown, TX 78626

Phone

(512) 863-9500

Fax

(512) 863-9562

NPI assigned

Apr 24, 2007

Last updated

Sep 8, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jonathan R Callia, D.D.S., M.S.

Title

Dentist

Phone

(512) 863-9500

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1220832000000",
    "number": "1932328333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1811 N. AUSTIN AVE.",
            "address_2": "SUITE 101",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "78626",
            "telephone_number": "512-863-9500",
            "fax_number": "512-863-9562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1811 N. AUSTIN AVE.",
            "address_2": "SUITE 101",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "78626",
            "telephone_number": "512-863-9500",
            "fax_number": "512-863-9562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL TEXAS PERIODONTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-24",
        "last_updated": "2008-09-08",
        "status": "A",
        "authorized_official_last_name": "CALLIA",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "512-863-9500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S., M.S."
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": "TX",
            "license": "20343",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Joseph Cessac, O.D.
• Jennifer Faith Chadwick Tavares, PHARMD
• Suparna Chakraborti, CCC-SLP

• Periodontics in Georgetown, TX
• Providers in Georgetown, TX by specialty
• Periodontics in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2008; 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.