Provider Demographics
NPI:1619004983
Name:POWELL, JULI S (DDS)
Entity Type:Individual
Prefix:DR
First Name:JULI
Middle Name:S
Last Name:POWELL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10017 DIANELLA LN
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-3036
Mailing Address - Country:US
Mailing Address - Phone:512-218-1130
Mailing Address - Fax:512-218-4423
Practice Address - Street 1:14205 N MO PAC EXPY
Practice Address - Street 2:SUITE 100
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78728-6527
Practice Address - Country:US
Practice Address - Phone:512-218-1130
Practice Address - Fax:512-218-4423
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX176781223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice