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LAKE TRAVIS PEDIATRIC DENTISTRY NPI 1508008590


NPI Information

NPI: 1508008590
Provider Name: LAKE TRAVIS PEDIATRIC DENTISTRY
Classification: Dentist - 1223P0221X
Entity Type: Organization

Specialization: Pediatric Dentistry

Address:
1008 RR 620 S
SUITE # 201
LAKEWAY, TX
ZIP 78734
Phone: (512) 263-1000
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LAKE TRAVIS PEDIATRIC DENTISTRY is a pediatric dentistry dentist in Lakeway, TX. The provider is an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. LAKE TRAVIS PEDIATRIC DENTISTRY NPI is 1508008590. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1008 RR 620 S
SUITE # 201
LAKEWAY, TX
ZIP 78734-631
Phone: (512) 263-1000

The provider's authorized official is Reza Arzegar .
The authorized official title is Vice President and has the following contact phone number (512) 263-1000.

The enumeration date for this NPI number is 4/6/2009 and was last updated on 4/6/2009.


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
11223P0221XDentistPediatric Dentistry22434TEXASYes

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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