Healthcare Provider Details

I. General information

NPI: 1306672167
Provider Name (Legal Business Name): LAIS ALBERTI FERREIRA DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/10/2024
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3301 NORTHLAND DR STE 201
AUSTIN TX
78731-4951
US

IV. Provider business mailing address

3301 NORTHLAND DR STE 201
AUSTIN TX
78731-4951
US

V. Phone/Fax

Practice location:
  • Phone: 512-879-1350
  • Fax: 512-879-1351
Mailing address:
  • Phone: 512-879-1350
  • Fax: 512-879-1351

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number42951
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: