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LAKELINE MALL FAMILY DENTAL
NPI 1104190594
Dentist - General Practice in Cedar Park, TX

Active since March 01, 2012
11200 LAKELINE MALL DR, #B1, CEDAR PARK, TX 78613(512) 448-4867(512) 335-7668 Get Directions Write a Review

NPPES record last updated: March 1, 2012. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Lakeline Mall Family Dental NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LAKELINE MALL FAMILY DENTAL (NPI 1104190594) is a healthcare organization registered as a general practice in Cedar Park, Texas and active in the NPI registry since March 2012. The organization lists Beau D Blankenship, Owner/president, as its authorized official.

NPPES Registry Identity

NPI1104190594
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameBEAU D BLANKENSHIP, DDS, PC
Location Address11200 LAKELINE MALL DR, #B1Cedar Park, TX 78613-1501
Mailing Address1215 Sledge DrAustin, TX 78734-6373 · (210) 722-9274 · Fax (512) 335-7668
Phone(512) 448-4867
Fax(512) 335-7668
Organization SubpartNo
Authorized OfficialBeau D BlankenshipOwner/president · (210) 722-9274
Enumeration DateMarch 1, 2012
✔ NPI 1104190594 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in TX · 22816
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
11200 LAKELINE MALL DR, Cedar Park, TX 78613
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Other Names 1

Doing Business AsLakeline Mall Family Dental

Other Identifiers 1

Medicaid181540911TX

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. PETER HYUN PAK O.D.
Optometrist
11200 LAKELINE MALL DR
CEDAR PARK, TX 78613
Williamson County (512) 698-8112
LAKELINE MALL FAMILY DENTAL
Dentist
11200 LAKELINE MALL DR, SUITE B01
CEDAR PARK, TX 78613
Williamson County (214) 390-9948
LAKELINE MALL FDC PA
Dentist
11200 LAKELINE MALL DR, STE B1
CEDAR PARK, TX 78613
Williamson County (512) 448-4867
LAKELINE EYE CENTER
Optometrist
11200 LAKELINE MALL DR, ST. E-5
CEDAR PARK, TX 78613
Williamson County (512) 401-6000
NORTHLAND HEARING CENTERS INC
Audiologist
11200 LAKELINE MALL DR
CEDAR PARK, TX 78613
Williamson County (512) 257-8122
DR. MEERA PATEL SAMPAT OD
Optometrist
11200 LAKELINE MALL DR
CEDAR PARK, TX 78613
Williamson County (512) 257-7070
LUXOTTICA OF AMERICA INC.
Eyewear Supplier
11200 LAKELINE MALL DR, LAKELINE MALL STE #E5
CEDAR PARK, TX 78613
Williamson County (512) 335-3098
LAKELINE EYECARE PLLC
Optometrist
11200 LAKELINE MALL DR, STE E5
CEDAR PARK, TX 78613
Williamson County (512) 401-6002

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Beau D Blankenship, Dds, PC's NPI number?

The NPI number for Beau D Blankenship, Dds, PC is 1104190594. It was assigned to this organization in the NPPES registry on March 1, 2012. The provider is doing business as Lakeline Mall Family Dental.

Where is Beau D Blankenship, Dds, PC located?

Beau D Blankenship, Dds, PC is located at 11200 Lakeline Mall Dr #b1, Cedar Park, TX 78613. The listed phone number is (512) 448-4867.

What is Beau D Blankenship, Dds, PC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

When was this NPI record last updated?

The NPPES record for Beau D Blankenship, Dds, PC was last updated on March 1, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.