Organization · Type 2 NPI

Austin Central Park Pediatric Dentistry

Pediatric Dentistry · Austin, TX

NPI number 1639597222 Active

Practice location

1005 W 38th St Ste 200
Austin, TX 78705-1042

Call (512) 330-4624 Map

Other practice locations

4308 N Quinlan Park Rd Ste 201, Austin, TX 78732-6071 · (512) 330-4624
13341 W US 290, Building 1-106, Austin, TX 78737 · (512) 330-4624

Specialties and licenses

Taxonomy	Code	License
Pediatric Dentistry Primary	1223P0221X	28784 (TX)

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.

2 other providers at this address

Other pediatric dentistry providers in Austin

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NPI record

NPI: 1639597222
Entity type: Organization (Type 2)
Issued: Apr 1, 2014
Last updated: Oct 21, 2024
Status: Active

Other names

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Central Park Pediatric Dentistry · doing business as
Central Park Pediatric Dentistry · doing business as

Authorized official

Dr. Daniel Crandall Johnson, DDS
Owner/dentist
(512) 330-4624

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1639597222

Austin Central Park Pediatric Dentistry's National Provider Identifier is 1639597222, issued on Apr 1, 2014. The primary taxonomy on file is Pediatric Dentistry (1223P0221X), and the practice location is in Austin, TX. The record was last updated on Oct 21, 2024.