SHANE ISTRE DENTAL ASSOCIATES (NPI# 1144312836) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144312836 |
| Entity Type | Organization |
| Organization Name | SHANE ISTRE DENTAL ASSOCIATES |
| Other Organization Name | SMILE CENTER PA |
| Practice Address |
1144 Airport Blvd #240 Austin TX 78702 |
| Practice Telephone | 5129297888 |
| Practice Fax Number | 5129298091 |
| Mailing Telephone | 5129297888 |
| Mailing Fax Number | 5129298091 |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2008-08-28 |
| Authorized Official Name | DR. MICHAEL SHAYNE ISTRE (OWNER PRESIDENT) |
| Authorized Official Telephone | 5125358911 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers | ||
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | TEXAS CHIP | G60109-3 | 01 |
| TX | 091333701 | 05 |
| Other Name | Type Code |
|---|---|
| SMILE CENTER PA | Doing Business As Name - Organization |
| Street Address |
1144 AIRPORT BLVD #240 |
| City | AUSTIN |
| State | TX |
| Zip Code | 78702 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801801816 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 1144 Airport Blvd, Austin, TX 78702-3163 | 2006-07-29 |
| 1255838108 | Omar Alejandro Fuentes Curiel | Pharmacist | 1144 Airport Blvd, Austin, TX 78702-3163 | 2018-04-08 |
| 1427305895 | Brendan Thomas Kane | Pharmacist | 1144 Airport Blvd, Austin, TX 78702 | 2012-08-04 |
| 1366770109 | Cassandra Jo Cano | Pharmacist | 1144 Airport Blvd, Austin, TX 78702-3163 | 2009-12-04 |
| 1619205457 | Mya Dalena Dao | Pharmacist | 1144 Airport Blvd, Austin, TX 78702-3163 | 2009-12-04 |
| 1851561740 | Michael Adrian Chavez | Optometrist | 1144 Airport Blvd, Ste 235, Austin, TX 78702-3163 | 2008-03-06 |
| 1992854632 | Sara Huizinga Gowin | Dentist | 1144 Airport Blvd, 240, Austin, TX 78702-3163 | 2007-01-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487207171 | Enamel Dentistry Saltillo, Pllc | Clinic/Center | 901 E. 5th Street, Suite 170, Austin, TX 78702 | 2019-07-22 |
| 1730678616 | Marci Lawson | Counselor | 1103 Cherico St Unit 3, Austin, TX 78702 | 2018-05-06 |
| 1730608340 | Gloria Robertson Hatfield | Social Worker | 501 N I-35, Ste 112, Austin, TX 78702 | 2017-09-14 |
| 1083063168 | Nona Mason | Nurse Practitioner | Ascension Seton Mccarthy Community Health Center, 2811 East 2nd Street, Austin, TX 78702 | 2016-06-08 |
| 1124487467 | Sarah Beth Mclaughlin | Social Worker | 1631 E. 2nd St., Bldg. E, Austin, TX 78702 | 2016-02-15 |
| 1972969590 | Austin Mind Body | Counselor | 905 E. 5th Street, Suite 102, Austin, TX 78702 | 2016-01-12 |
| 1972976777 | Stacy Griffin | Social Worker | 1631 E. 2nd Street, Austin, TX 78702 | 2015-11-03 |
| 1396111894 | Jocelyn Jarmon | Health Maintenance Organization | 1803 Ulit Avenue, Austin, TX 78702 | 2015-08-19 |
| 1396142972 | Jillessa Fiorillo | Social Worker | 1631-d East 2nd Street, Austin, TX 78702 | 2014-11-26 |
| 1518390962 | Emily Anna Murray | Physical Therapist | 1621 E 6th St # 11488, Austin, TX 78702 | 2013-08-20 |
| Find all providers in zip 78702 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033733365 | Ernesto Carmona Jr Dds PC | Dentist | 10125a Lake Creek Pkwy, Austin, TX 78729-1711 | 2020-06-02 |
| 1205360252 | Central Texas Implant Center Pllc | Dentist | 7320 N Mo Pac Expy, #200, Austin, TX 78731-2338 | 2017-04-17 |
| 1811343718 | T & S Omfs Pllc | Dentist | 1015 W 34th St, Austin, TX 78705-2008 | 2016-05-10 |
| 1932450020 | Garey Chayra | Dentist | 6352 Tasajillo Trl, Austin, TX 78739-1416 | 2012-09-28 |
| 1497938468 | Matthew C. Largent | Dentist | 4306 Medical Pkwy Ste 2, Austin, TX 78756-3312 | 2007-12-12 |
| 1104008861 | Travis W. Kern | Dentist | 7800 Mopac Expwy, Suite 270, Austin, TX 78759 | 2007-12-04 |
| 1730373580 | Claude-jean Langevin | Dentist | 911 W 38th St Ste 101, Austin, TX 78705-9918 | 2007-09-04 |
| 1407917800 | Henry Marcantoni | Dentist | 10801 N Mo Pac Expy, Bldg. 2 Ste.130, Austin, TX 78759-5459 | 2006-12-12 |
| 1346330396 | James John Flaggert IIi | Dentist | 11615 Angus Rd., Suite 118, Austin, TX 78759-4065 | 2006-10-13 |
| 1114018124 | Central Texas Oral Surgery Assc. | Dentist | 3200 Red River, #400, Austin, TX 78705 | 2006-09-27 |
| 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.