Green Apple Pediatric Dentistry, PLLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

24128 Issued in TX

Legal business name

GREEN APPLE PEDIATRIC DENTISTRY, PLLC

Practice address

11601 US Hwy 290 West
Suite 105
Austin, TX 78737

Phone

(512) 917-4550

NPI assigned

Aug 21, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Maria Evelina Guerrero, DDS

Title

Pediatric Dentist/Managing Member

Phone

(210) 287-1535

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1408579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1408579200000",
    "number": "1972902427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "904 WEST AVE",
            "address_2": "SUITE 203",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787012236",
            "telephone_number": "210-287-1535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11601 US HWY 290 WEST",
            "address_2": "SUITE 105",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78737",
            "telephone_number": "512-917-4550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREEN APPLE PEDIATRIC DENTISTRY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-21",
        "last_updated": "2014-08-21",
        "status": "A",
        "authorized_official_last_name": "GUERRERO",
        "authorized_official_first_name": "MARIA",
        "authorized_official_middle_name": "EVELINA",
        "authorized_official_title_or_position": "PEDIATRIC DENTIST/MANAGING MEMBER",
        "authorized_official_telephone_number": "210-287-1535",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TX",
            "license": "24128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatric Dentistry in Austin, TX
• Providers in Austin, TX by specialty
• Pediatric Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2014; 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.