Provider Demographics
NPI:1598840506
Name:JERRY P KATZ DDS INC
Entity Type:Organization
Organization Name:JERRY P KATZ DDS INC
Other - Org Name:JERRY P KATZ DDS PRESIDENT
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:KATZ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:512-343-0033
Mailing Address - Street 1:3818 SPICEWOOD SPRINGS ROAD
Mailing Address - Street 2:#200
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759
Mailing Address - Country:US
Mailing Address - Phone:512-343-0033
Mailing Address - Fax:512-343-2859
Practice Address - Street 1:3818 SPICEWOOD SPRINGS ROAD
Practice Address - Street 2:#200
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759
Practice Address - Country:US
Practice Address - Phone:512-343-0033
Practice Address - Fax:512-343-2859
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX87961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty