Provider Demographics
NPI:1407338874
Name:SOOMAR, LAUREN OLIVIA (DDS)
Entity Type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:OLIVIA
Last Name:SOOMAR
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:
Other - Last Name:SIEGERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1409 SINGLETON AVE
Mailing Address - Street 2:UNIT A
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78702
Mailing Address - Country:US
Mailing Address - Phone:956-428-5322
Mailing Address - Fax:956-428-7986
Practice Address - Street 1:3701 GATTIS SCHOOL ROAD
Practice Address - Street 2:SUITE 100
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78664
Practice Address - Country:US
Practice Address - Phone:512-716-3101
Practice Address - Fax:512-369-3476
Is Sole Proprietor?:No
Enumeration Date:2018-09-03
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX343681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice