OrganizationActive
Beau D Blankenship, DDS, PC
NPI 1104190594 · General Practice Dentistry · Cedar Park, TX
Beau D Blankenship, DDS, PC is a General Practice Dentistry organization in Cedar Park, TX (NPI 1104190594).
Provider details
- NPI number
- 1104190594
- Entity type
- Organization
- Primary specialty
- General Practice DentistryDental Providers
- Organization subpart
- No
- Authorized official
- Beau Blankenship, Owner/President(210) 722-9274
- License
- 22816 (TX)
Specialties & taxonomies
Dental Providers
Profile Score
Detailed profile(80/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
14 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
#b1
Cedar Park, TX 78613-1501
Phone: (512) 448-4867
Fax: (512) 335-7668
Approximate (ZIP-level) locationGet directions
Mailing address
1215 Sledge Dr
Austin, TX 78734-6373
Other names (DBA / former)
- Doing business as
- Lakeline Mall Family Dental
Registry dates
- Enumerated
- 2012-03-01
- Last updated
- 2012-03-01
Frequently asked questions
- What is Beau D Blankenship, DDS, PC's NPI number?
- Beau D Blankenship, DDS, PC's National Provider Identifier (NPI) is 1104190594, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Beau D Blankenship, DDS, PC?
- Beau D Blankenship, DDS, PC is classified in the NPPES registry as General Practice Dentistry (Dental Providers).
- Where is Beau D Blankenship, DDS, PC located?
- Beau D Blankenship, DDS, PC's practice location on file with NPPES is 11200 Lakeline Mall Dr, Cedar Park, TX 78613-1501.
- What is Beau D Blankenship, DDS, PC's phone number?
- The practice phone number listed in the NPPES registry for Beau D Blankenship, DDS, PC is (512) 448-4867.
- Who is the authorized official for Beau D Blankenship, DDS, PC?
- The authorized official listed on Beau D Blankenship, DDS, PC's NPPES record is Beau Blankenship, Owner/President. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Beau D Blankenship, DDS, PC's NPI active?
- Yes — Beau D Blankenship, DDS, PC's NPI (1104190594) is active in the NPPES registry as of the last update on 2012-03-01.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.