Provider Demographics
NPI:1255687026
Name:JVG & ASSOCIATES LTD., LLP
Entity Type:Organization
Organization Name:JVG & ASSOCIATES LTD., LLP
Other - Org Name:WILDFLOWER ORTHODONTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT OF THE GENERAL PARTNERSHI
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:GIASI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:512-520-7585
Mailing Address - Street 1:1701 RED BUD LN
Mailing Address - Street 2:#200
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78664-3835
Mailing Address - Country:US
Mailing Address - Phone:512-520-7585
Mailing Address - Fax:
Practice Address - Street 1:1701 RED BUD LN
Practice Address - Street 2:#200
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78664-3835
Practice Address - Country:US
Practice Address - Phone:512-520-7585
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-31
Last Update Date:2012-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX220821223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty