Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Tx Southern Dental PPO PC

Organization Dentist · NPI 1821974056

Tx Southern Dental PPO PC is a Dentist in Austin, Texas. Registered with an NPI since 2025.

In the registry since
2025
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

3624 N Hills Dr Ste A103
Austin, TX 78731-3061
Phone: (512) 346-3631
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X

Record details

NPI number1821974056
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationTx Southern Dental PPO PC
Authorized official Erika Menjivar — Sr. Credentialing Specialist · (469) 596-6137
Other names Jason Black, Dds
NPI enumeratedAugust 13, 2025
Last updated in NPPESAugust 13, 2025
Certification dateAugust 13, 2025
Mailing address5830 Granite Pkwy Ste 780, Plano, TX 75024-6775

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