OrganizationActive
Lakeline Mall Family Dental
NPI 1053753764 · Dentist · Cedar Park, TX
Lakeline Mall Family Dental is a Dentist organization in Cedar Park, TX (NPI 1053753764).
Provider details
- NPI number
- 1053753764
- Entity type
- Organization
- Primary specialty
- DentistDental Providers
- Organization subpart
- No
- Authorized official
- Justin Cordon, Manager(214) 390-9948
Specialties & taxonomies
Dental Providers
Profile Score
Detailed profile(77/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
12 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
11200 Lakeline Mall Dr
Suite B01
Cedar Park, TX 78613-1501
Phone: (214) 390-9948
Approximate (ZIP-level) locationGet directions
Mailing address
11200 Lakeline Mall Dr
Cedar Park, TX 78613-1501
Registry dates
- Enumerated
- 2013-07-23
- Last updated
- 2013-07-23
Frequently asked questions
- What is Lakeline Mall Family Dental's NPI number?
- Lakeline Mall Family Dental's National Provider Identifier (NPI) is 1053753764, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Lakeline Mall Family Dental?
- Lakeline Mall Family Dental is classified in the NPPES registry as Dentist (Dental Providers).
- Where is Lakeline Mall Family Dental located?
- Lakeline Mall Family Dental's practice location on file with NPPES is 11200 Lakeline Mall Dr, Cedar Park, TX 78613-1501.
- What is Lakeline Mall Family Dental's phone number?
- The practice phone number listed in the NPPES registry for Lakeline Mall Family Dental is (214) 390-9948.
- Who is the authorized official for Lakeline Mall Family Dental?
- The authorized official listed on Lakeline Mall Family Dental's NPPES record is Justin Cordon, Manager. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Lakeline Mall Family Dental's NPI active?
- Yes — Lakeline Mall Family Dental's NPI (1053753764) is active in the NPPES registry as of the last update on 2013-07-23.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.