LAKELINE MALL FDC PA (NPI# 1275791410) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275791410 |
| Entity Type | Organization |
| Organization Name | LAKELINE MALL FDC PA |
| Practice Address |
11200 Lakeline Mall Dr Ste B1 Cedar Park TX 78613-1502 |
| Practice Telephone | 5124484867 |
| Practice Fax Number | 5123357668 |
| Mailing Telephone | 5124484867 |
| Mailing Fax Number | 5123357668 |
| Enumeration Date | 2008-05-23 |
| Last Update Date | 2008-05-23 |
| Authorized Official Name | LYNN ARMSTRONG (REGIONAL MANAGER) |
| Authorized Official Telephone | 5053284857 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 0008481 | TX | Dental Providers |
| Street Address |
11200 LAKELINE MALL DR STE B1 |
| City | CEDAR PARK |
| State | TX |
| Zip Code | 78613-1502 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558417105 | Luxottica of America Inc. | Eyewear Supplier (Equipment, not the service) | 11200 Lakeline Mall Dr, Lakeline Mall Ste #e5, Cedar Park, TX 78613-1501 | 2007-01-26 |
| 1992180624 | Lakeline Eyecare Pllc | Optometrist | 11200 Lakeline Mall Dr, Ste E5, Cedar Park, TX 78613-1501 | 2015-07-23 |
| 1194157487 | Samira Foshat Alejos | Optometrist | 11200 Lakeline Mall Dr, H-5, Cedar Park, TX 78613-1501 | 2013-08-08 |
| 1053753764 | Lakeline Mall Family Dental | Dentist | 11200 Lakeline Mall Dr, Suite B01, Cedar Park, TX 78613-1501 | 2013-07-23 |
| 1104190594 | Beau D Blankenship, Dds, PC | Dentist | 11200 Lakeline Mall Dr, #b1, Cedar Park, TX 78613-1501 | 2012-03-01 |
| 1285934539 | Lakeline Eye Center | Optometrist | 11200 Lakeline Mall Dr, St. E-5, Cedar Park, TX 78613-1501 | 2010-11-02 |
| 1326355470 | Northland Hearing Centers Inc | Audiologist-Hearing Aid Fitter | 11200 Lakeline Mall Dr, Cedar Park, TX 78613-1501 | 2010-09-10 |
| 1013145036 | Peter Hyun Pak | Optometrist | 11200 Lakeline Mall Dr, Cedar Park, TX 78613-1501 | 2009-06-29 |
| 1871741926 | Melton Carey Duke | Hearing Instrument Specialist | 11200 Lakeline Mall Dr, Sears Hearing Aid Ctr, Cedar Park, TX 78613 | 2008-09-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841891280 | Honor Audiology, LLC | Audiologist | 1807 Cypress Creek, Ste 106, Ceder Park, TX 78613 | 2020-11-03 |
| 1750980801 | Sheneil Roberts | Pharmacist | 101 Commercial Pkwy, Cedar Park, TX 78613 | 2020-10-20 |
| 1821606674 | Whitney Olivia White | Dentist | 4807 183a, Ste 100, Cedar Park, TX 78613 | 2020-07-17 |
| 1427681436 | Alex Parnell | Marriage & Family Therapist | 3000 Polar Lane, 602, Cedar Park, TX 78613 | 2020-02-18 |
| 1497216642 | Rolling Hills Healthcare, Inc. | Hospice Care, Community Based | 1101 Arrow Point Dr Ste 301, Cedar Park, TX 78613 | 2019-03-29 |
| 1265907828 | Mary Kathleen Williams | Clinical Nurse Specialist | 1103 Pagedale Drive, Cedar Park, TX 78613 | 2018-10-10 |
| 1982187514 | Elizabeth Harwell | Physical Therapy Assistant | 1500 Cottonwood Creek Trail, Cedar Park, TX 78613 | 2018-09-10 |
| 1346722246 | Riddhi Gohel | Optometrist | 11200 Lakeline Mall Dr Ste H5, Cedar Park, TX 78613 | 2018-09-06 |
| 1528546736 | Lakeline Emergency Center, LLC | Clinic/Center | 1860 S. Lakeline Blvd, Cedar Park, TX 78613 | 2018-07-31 |
| 1710464458 | Kelsey Alyse Hayes | Dietitian, Registered | 1401 Medical Pkwy B, Suite 101, Cedar Park, TX 78613 | 2018-07-25 |
| Find all providers in zip 78613 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821606674 | Whitney Olivia White | Dentist | 4807 183a, Ste 100, Cedar Park, TX 78613 | 2020-07-17 |
| 1770001562 | Fernando Daniel Ruiz | Dentist | 2800 E Whitestone Blvd Ste 225, Cedar Park, TX 78613-7276 | 2017-09-01 |
| 1487178059 | William Hardenbergh | Dentist | 1468 E Whitestone Blvd Ste 500, Cedar Park, TX 78613-0019 | 2017-07-26 |
| 1811418486 | Kelsi Lewis | Dentist | 1201 N Bell Blvd # 102, Cedar Park, TX 78613-7018 | 2017-07-04 |
| 1073052411 | Britex Dental of Cedar Park Pllc | Dentist | 5001 183a Toll Rd, Suite R300, Cedar Park, TX 78613-7903 | 2017-02-17 |
| 1922467760 | Ideal Dental Brush Cedar Park Pllc | Dentist | 1201 N Bell Blvd, Cedar Park, TX 78613-7018 | 2016-02-22 |
| 1407228158 | William Batten | Dentist | 908 W Whitestone Blvd Ste 400, Cedar Park, TX 78613-7951 | 2015-10-21 |
| 1801293469 | Ck Dental Group | Dentist | 920 N Vista Ridge Blvd # 700, Cedar Park, TX 78613-7637 | 2014-11-25 |
| 1710399886 | Carus Dental PC | Dentist | 1130 Cottonwood Creek Trail, Building A., Suite 2, Cedar Park, TX 78613 | 2014-05-23 |
| 1427326875 | Hyun-do Joo | Dentist | 401 E Whitestone Blvd Ste 105, Cedar Park, TX 78613-9051 | 2011-12-13 |
| Find all providers in CEDAR PARK | ||||
| City | CEDAR PARK |
| Zip Code | 78613 |
Please comment or provide details below to improve the information on LAKELINE MALL FDC PA.
| 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.