Lakeline Ranch Dental

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

License

25493 Issued in TX

Legal business name

LAKELINE RANCH DENTAL

Practice address

10900 Lakeline Mall Dr
Suite 250
Austin, TX 78717-5924

Phone

(512) 583-0700

Fax

(512) 583-0700

NPI assigned

Jan 31, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Ardalan Zahedi, DDS

Title

Owner

Phone

(512) 583-0700

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1391126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1391126400000",
    "number": "1972926699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10900 LAKELINE MALL DR",
            "address_2": "SUITE 250",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787175924",
            "telephone_number": "512-583-0700",
            "fax_number": "512-583-0700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10900 LAKELINE MALL DR",
            "address_2": "SUITE 250",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787175924",
            "telephone_number": "512-583-0700",
            "fax_number": "512-583-0700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKELINE RANCH DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-31",
        "last_updated": "2014-01-31",
        "status": "A",
        "authorized_official_last_name": "ZAHEDI",
        "authorized_official_first_name": "ARDALAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "512-583-0700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "TX",
            "license": "25493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marion Elizabeth Lake, PT
• Natalie Jane Lake, C.P.M., L.M.
• Tanya Lake
• Lakecreek Family Dental
• Lakeline Ranch Dental
• Lakeview Family Health Clinic
• Lakeway Dental Office, P.a.
• Lakeway Pediatric Dental, PLLC
• Lakeway Psychiatry and Behavioral Health
• Lakeway Smiles

• Preferred Provider Organization in Austin, TX
• Providers in Austin, TX by specialty
• Preferred Provider Organization in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 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.