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TX SOUTHERN DENTAL PPO PC
NPI 1821974056
Dentist in Austin, TX

Active since August 13, 2025
3624 N HILLS DR STE A103, AUSTIN, TX 78731(512) 346-3631 Get Directions Write a Review

NPPES record last updated: August 13, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Tx Southern Dental Ppo Pc NPPES

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

TX SOUTHERN DENTAL PPO PC (NPI 1821974056), doing business as Jason Black, Dds, is a healthcare organization registered as a dentist in Austin, Texas and active in the NPI registry since August 2025. The organization lists Erika Melissa Menjivar, Sr. Credentialing Specialist, as its authorized official.

NPPES Registry Identity

NPI1821974056
Entity TypeOrganization
Primary Taxonomy122300000X
Legal Business NameTX SOUTHERN DENTAL PPO PC
Location Address3624 N HILLS DR STE A103Austin, TX 78731-3061
Mailing Address5830 Granite Pkwy Ste 780Plano, TX 75024-6775
Phone(512) 346-3631
Organization SubpartYes
Authorized OfficialErika Melissa MenjivarSr. Credentialing Specialist · (469) 596-6137
Enumeration DateAugust 13, 2025
NPPES CertifiedAugust 13, 2025
✔ NPI 1821974056 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
Definition
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.
3624 N HILLS DR STE A103, Austin, TX 78731
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Other Names 1

Doing Business AsJason Black, Dds

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES

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

DR. JASON ALEXANDER BLACK DDS
Dentist (General Practice)
3624 N HILLS DR STE A103
AUSTIN, TX 78731
Travis County (512) 346-3631

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 Tx Southern Dental Ppo PC's NPI number?

The NPI number for Tx Southern Dental Ppo PC is 1821974056. It was assigned to this organization in the NPPES registry on August 13, 2025. The provider is doing business as Jason Black, DDS.

Where is Tx Southern Dental Ppo PC located?

Tx Southern Dental Ppo PC is located at 3624 N Hills Dr Ste A103, Austin, TX 78731. The listed phone number is (512) 346-3631.

What is Tx Southern Dental Ppo PC's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

When was this NPI record last updated?

The NPPES record for Tx Southern Dental Ppo PC was last updated on August 13, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months 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.