Provider Demographics
NPI:1679740054
Name:CENTER FOR COSMETIC DENTISTRY WEST AUSTIN
Entity type:Organization
Organization Name:CENTER FOR COSMETIC DENTISTRY WEST AUSTIN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:G
Authorized Official - Last Name:SCHMIDT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:512-328-1500
Mailing Address - Street 1:5656 BEE CAVE RD
Mailing Address - Street 2:
Mailing Address - City:WEST LAKE HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:78746-5280
Mailing Address - Country:US
Mailing Address - Phone:512-328-1500
Mailing Address - Fax:512-328-8650
Practice Address - Street 1:5656 BEE CAVE RD
Practice Address - Street 2:
Practice Address - City:WEST LAKE HILLS
Practice Address - State:TX
Practice Address - Zip Code:78746-5280
Practice Address - Country:US
Practice Address - Phone:512-328-1500
Practice Address - Fax:512-328-8650
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-14
Last Update Date:2008-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13991223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty