LSPD AT CIRCLE C, PLLC (NPI# 1104364710) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104364710 |
| Entity Type | Organization |
| Organization Name | LSPD AT CIRCLE C, PLLC |
| Other Organization Name | LONE STAR PEDIATRIC DENTAL |
| Practice Address |
5900 W Slaughter Ln Ste 470 Austin TX 78749-6513 |
| Mailing Address |
505 E Huntland Dr Ste 340 Austin TX 78752-3745 |
| Practice Telephone | 5122062929 |
| Enumeration Date | 2017-02-02 |
| Last Update Date | 2017-02-02 |
| Authorized Official Name | MARTY MONTGOMERY (OWNER) |
| Authorized Official Telephone | 5122062975 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
Dental Providers | ||
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
Dental Providers |
| Other Name | Type Code |
|---|---|
| Lone Star Pediatric Dental | Doing Business As Name - Organization |
| Street Address |
5900 W SLAUGHTER LN STE 470 |
| City | AUSTIN |
| State | TX |
| Zip Code | 78749-6513 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144863812 | Atx Sleep Center of Austin | Clinic/Center | 5920 W William Cannon Dr Bldg 6 Ste 110, Austin, TX 78749 | 2019-10-24 |
| 1194366740 | Monica Leann Woodworth | Behavioral Analyst | 5700 S Mopac Expy, C310, Austin, TX 78749 | 2019-10-04 |
| 1346894045 | Brianna Gonzalez | Behavioral Analyst | 5700 S Mopac Expy C310, Austin, TX 78749 | 2019-07-31 |
| 1811549603 | Austin Michael Arzaga | Pharmacist | 6600 Mopac Expressway South, Austin, TX 78749 | 2019-07-11 |
| 1922565092 | Ashley Harmon | Social Worker | 5417 S Mopac Expy, 418, Austin, TX 78749 | 2019-02-26 |
| 1316391139 | National Vision, Inc. | Technician/Technologist | 5300 S Mopac Expw, Ste 102 & 102c, Austin, TX 78749 | 2016-04-18 |
| 1972976322 | P&h Services, LLC | Durable Medical Equipment & Medical Supplies | 5920 W. William Cannon Dr., Bldg 6, Ste. 225, Austin, TX 78749 | 2015-11-06 |
| 1023495207 | Oncall Emergency Center Circle C LLC | Clinic/Center | 5701 W. Slaughter Lane, Blg G Ste 101, Austin, TX 78749 | 2015-04-27 |
| 1447685953 | Sally Vanessa Moser | Dentist | 3601 W. William Cannon Dr, Bldg 4, Ste 500, Austin, TX 78749 | 2013-09-04 |
| 1386987576 | Qiwei Paulson | Internal Medicine | 7504 Orrick Dr, Austin, TX 78749 | 2013-04-05 |
| Find all providers in zip 78749 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| 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. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558832972 | Belterra Kids Teeth | Dentist | 165 Hargraves Dr Ste M100, Austin, TX 78737-4810 | 2018-12-11 |
| 1073051413 | Bash Braker LLC | Dentist | 1139 W Braker Ln, Ste 201, Austin, TX 78758 | 2017-02-06 |
| 1336519313 | Longhorn Pediatric Dentistry and Orthodontics | Dentist | 4638 W Gate Blvd, Austin, TX 78745-1461 | 2015-10-02 |
| 1659749810 | Specialty Dental Partners of Austin Pllc | Dentist | 4308 N Quinlan Park Rd Ste 201, Austin, TX 78732-6071 | 2015-09-04 |
| 1003202060 | Jared Poplin D.m.d., Pllc | Dentist | 6850 Austin Center Blvd Ste 220, Austin, TX 78731-3131 | 2015-04-07 |
| 1679964787 | Alexander Y Shau | Dentist | 13616 N Hwy 183 Unit A, Austin, TX 78750-2312 | 2015-02-10 |
| 1972902427 | Green Apple Pediatric Dentistry, Pllc | Dentist | 11601 Us Hwy 290 West, Suite 105, Austin, TX 78737 | 2014-08-21 |
| 1902216989 | Kyle Raymond Pa | Dentist | 5656 Bee Caves Rd Ste B104, Austin, TX 78746 | 2014-04-30 |
| 1447595855 | Rock That Smile Pediatric Dentistry Pllc | Dentist | 14005 N. Hwy 183, #800, Austin, TX 78717 | 2012-12-11 |
| 1215280557 | North Austin Pediatric Dental, Pllc | Dentist | 8716 Research Blvd # 125, Austin, TX 78758-6420 | 2012-10-24 |
| Find all providers in AUSTIN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.