Lakeline Mall Family Dental

LBN: Beau D Blankenship, Dds, Pc
Lakeline Mall Family Dental is an health care organization with primary practice located at 11200 Lakeline Mall Dr #B1, Cedar Park TX 78613-1501. The organization recently has only one registered license in Dental Providers / General Practice, which is considered as the primary health care specialty. Beau D Blankenship, Dds, Pc can be contacted via phone (512) 448-4867, or through Blankenship, Beau D via phone (210) 722-9274.

Contact Information

Primary practice address
11200 Lakeline Mall Dr #B1 Cedar Park TX 78613-1501
Phone: (512) 448-4867
Fax: (512) 335-7668
Website:
Map and Directions
Authorized official contact:
Name: Blankenship, Beau D Doctor of Dental Surgery (DDS)
Phone: (210) 722-9274

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 22816 Texas

Profile Details

NPI number 1104190594
LBN Legal business name Beau D Blankenship, Dds, Pc
DBA Doing business as Lakeline Mall Family Dental
Authorized official Blankenship, Beau D Doctor of Dental Surgery (DDS)
Entity Organization
Organization subpart 1 No
Enumeration date Mar 1st, 2012
Last updated Mar 1st, 2012 - about 13 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104190594 NPPES
Texas MEDICAID 181540911

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