# J. KIP NIELSON DDS PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Starlight Dental and Orthodontics
- **Organization subpart:** No

## Provider details

- **NPI number:** 1558742593
- **Authorized official:** JED CODY NIELSON DDS (PROVIDER)
- **Authorized official phone:** (512) 250-8101

## Contact information

- **Practice address:** 10123 LAKE CREEK PKWY, BLDG 2, AUSTIN, TX 78729-1754
- **Practice address phone:** (512) 250-8101
- **Mailing address:** 10123 LAKE CREEK PKWY, BLDG 2, AUSTIN, TX 78729-1754
- **Mailing address phone:** (512) 250-8101

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | — | Yes |

## Other

- **Enumeration date:** 06/16/2015
- **Last updated:** 06/16/2015