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PFLUGERVILLE PERIODONTICS NPI 1255842159


NPI Information

NPI: 1255842159
Provider Name: PFLUGERVILLE PERIODONTICS
Classification: Dentist - 1223P0300X
Entity Type: Organization

Specialization: Periodontics

CLIA Number: 45D2145276

Address:
2911 A W GRIMES BLVD
PFLUGERVILLE, TX
ZIP 78660
Phone: (512) 990-8550
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PFLUGERVILLE PERIODONTICS is a periodontics dentist in Pflugerville, TX. The provider is that specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. PFLUGERVILLE PERIODONTICS NPI is 1255842159. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2911 A W GRIMES BLVD
PFLUGERVILLE, TX
ZIP 78660-458
Phone: (512) 990-8550

The provider's authorized official is Jonathan Callia .
The authorized official title is Shareholder and has the following contact phone number (512) 990-8550.

The CLIA number assigned to this NPI record is 45D2145276 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/18/2017 and was last updated on 10/18/2017.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223P0300XDentistPeriodontics20343TEXASYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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