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SEDADENT ANESTHESIA SERVICES NPI 1144597931


NPI Information

NPI: 1144597931
Provider Name: SEDADENT ANESTHESIA SERVICES
Classification: Dentist - 1223D0004X
Entity Type: Organization

Specialization: Dentist Anesthesiologist

Address:
1608 OAK FOREST DR
ROUND ROCK, TX
ZIP 78681
Phone: (512) 909-3171
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SEDADENT ANESTHESIA SERVICES is a dentist anesthesiologist dentist in Round Rock, TX. The provider is a dentist who has successfully completed an accredited postdoctoral anesthesiology residency training program for dentists of two or more years duration, in accord with Commission on Dental Accreditation's Standards for Dental Anesthesiology Residency Programs, and/or meets the eligibility requirements for examination by the American Dental Board of Anesthesiology. SEDADENT ANESTHESIA SERVICES NPI is 1144597931. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1608 OAK FOREST DR
ROUND ROCK, TX
ZIP 78681-513
Phone: (512) 909-3171
Fax: (512) 246-3678

The provider's authorized official is Jarom Cooper Heaton .
The authorized official title is Owner and has the following contact phone number (512) 940-8601.

The enumeration date for this NPI number is 11/21/2011 and was last updated on 7/8/2013.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223G0001XDentistGeneral PracticeNo
21223D0004XDentistDentist AnesthesiologistYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11949372MEDICAIDTEXAS

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: 4/28/2024

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