Provider Demographics
NPI:1629233077
Name:POPLIN, JARED (DMD)
Entity Type:Individual
Prefix:DR
First Name:JARED
Middle Name:
Last Name:POPLIN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6850 AUSTIN CENTER BLVD
Mailing Address - Street 2:STE 220
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-3201
Mailing Address - Country:US
Mailing Address - Phone:512-346-1283
Mailing Address - Fax:512-346-4975
Practice Address - Street 1:6850 AUSTIN CENTER BLVD
Practice Address - Street 2:STE 220
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-3201
Practice Address - Country:US
Practice Address - Phone:512-346-1283
Practice Address - Fax:512-346-4975
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-25
Last Update Date:2015-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0376131223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry