Blooming Dental, PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

BLOOMING DENTAL, PLLC

Practice address

111 N Vista Ridge Blvd Ste 100
Cedar Park, TX 78613-2425

Phone

(512) 250-2356

Fax

(512) 532-6516

NPI assigned

Apr 6, 2021

Organization subpart

No

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

Authorized official

Name

Dr. James Lee, DDS

Title

Member

Phone

(512) 250-2356

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1617667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617667200000",
    "number": "1982283032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 N VISTA RIDGE BLVD STE 100",
            "city": "CEDAR PARK",
            "state": "TX",
            "postal_code": "786132425",
            "telephone_number": "512-250-2356",
            "fax_number": "512-532-6516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 N VISTA RIDGE BLVD STE 100",
            "city": "CEDAR PARK",
            "state": "TX",
            "postal_code": "786132425",
            "telephone_number": "512-250-2356",
            "fax_number": "512-532-6516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOOMING DENTAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-06",
        "last_updated": "2021-04-06",
        "certification_date": "2021-04-06",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "512-250-2356",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS STATE BOARD LICENSE",
            "identifier": "19039",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erin Blackwell, PHARMD
• Dustin Blair
• BLC Acupuncture & Integrative Medicine, PLLC
• Kenneth Bloodworth
• Blooming Dental PLLC
• Tyler Bludau
• Bluebird Behavioral Solutions, LLC
• Aric Blythe, PT, DPT
• Stephen S Bodi, PA-C
• Sandeep Bodige, D.O.

• Dental Clinic/Center in Cedar Park, TX
• Providers in Cedar Park, TX by specialty
• Dental Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 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.