Update this page – If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS.
Organization
SOUTHPARK SMILES, PC
Active
Organization
SOUTHPARK SMILES, PC
Active
Other names
Eastside Smiles
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACKSON R BOOTH DDS (PRESIDENT)
(512) 282-7200
Entity
Organization
Contact information
Practice address
4410 E RIVERSIDE DR, SUITE 150, AUSTIN, TX 78741-4799
(512) 385-4700
Mailing address
9500 SOUTH IH 35, SUITE E 400, AUSTIN, TX 78748-1990
(512) 282-7200
(512) 282-7204
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
23496
TX
Other
Enumeration date
02/25/2010
Last updated
02/25/2010
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up