is a Dental Clinic in Cedar Park, Texas. It is located at 11200 Lakeline Mall Dr, #b1, Cedar Park, TX and its contact number is 512-448-4867. The authorized person for is Dr. Beau D Blankenship
who is Owner/president of the clinic and their contact number is 210-722-9274. Other organizations associated with this clinic are Lakeline Mall Family Dental, Beau D Blankenship, Dds, Pc, Lakeline Mall Fdc Pa, The primary license number for is 22816 (General Practice) in Texas. Clinic caters to patients of all ages for their dental care needs. Dentists at the clinic are responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
Complete Clinic Profile:
Clinic speciality, address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointments.
Name:
Specialization:
General Practice Dentistry
Clinic Address:
11200 Lakeline Mall Dr, #b1, Cedar Park, Texas, 78613-1501
Phone:
512-448-4867
Fax:
512-335-7668
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints for this clinic are as below. Person's position and contact details are also mentioned below.
Name:
Dr. Beau D Blankenship
Position:
Owner/president
Contact Number:
210-722-9274
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details for clinic are as mentioned below.
NPI Number:
1104190594
NPI Enumeration Date:
01 Mar, 2012
NPI Last Update On:
01 Mar, 2012
Other Associated Organizations:
Other organizations which are associated with this clinic are as mentioned below. These organization share the same address but have similar or different specialization.
Speciality of these organizations are also mentioned below.
Name
Specialization
NPI Number
Lakeline Mall Family Dental
Dentistry
1053753764
Beau D Blankenship, Dds, Pc
General Practice Dentistry
1104190594
Lakeline Mall Fdc Pa
Dentistry
1275791410
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for are as mentioned below.
Specialization
License Number
State
Status
General Practice
22816
Texas
Primary
Other Medical Identifiers:
Other legacy medical identifiers of the clinic such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
Identifier
Type
State
Issuer
181540911
Medicaid
Texas
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
Address:
1215 Sledge Dr, Austin, Texas
Zip:
78734-6373
Phone Number:
210-722-9274
Fax Number:
512-335-7668
Patients can reach at 11200 Lakeline Mall Dr, #b1, Cedar Park, Texas or can call to book an appointment on 512-448-4867. Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 10 February, 2025.