Kids Tooth Team South Austin PLLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

KIDS TOOTH TEAM SOUTH AUSTIN PLLC

Practice address

1217 W Slaughter LN Ste 140
Austin, TX 78748-6916

Phone

(512) 523-4774

Fax

(512) 355-7030

NPI assigned

Jun 16, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Alexandra Barton Otto, DDS

Title

Director

Phone

(239) 293-0387

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

{
    "created_epoch": "1623801600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623801600000",
    "number": "1972171932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1245 MAIN ST STE 300",
            "city": "BUDA",
            "state": "TX",
            "postal_code": "786102269",
            "telephone_number": "512-523-4774",
            "fax_number": "512-355-7030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1217 W SLAUGHTER LN STE 140",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787486916",
            "telephone_number": "512-523-4774",
            "fax_number": "512-355-7030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDS TOOTH TEAM SOUTH AUSTIN PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-16",
        "last_updated": "2021-06-16",
        "certification_date": "2021-06-16",
        "status": "A",
        "authorized_official_last_name": "OTTO",
        "authorized_official_first_name": "ALEXANDRA",
        "authorized_official_middle_name": "BARTON",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "239-293-0387",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "info@kidstoothteam.com",
            "affiliation": "N",
            "address_1": "1217 W Slaughter Ln Ste 140",
            "city": "Austin",
            "state": "TX",
            "country_code": "US",
            "postal_code": "787486916",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Pediatric Dentistry in Austin, TX
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2021; 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.