Healthcare Provider Details

I. General information

NPI: 1134014236
Provider Name (Legal Business Name): DERRICK D FLINT, MD, DDS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2025
Last Update Date: 06/10/2025
Certification Date: 06/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

119 CIMARRON PARK LOOP STE C
BUDA TX
78610-2839
US

IV. Provider business mailing address

119 CIMARRON PARK LOOP STE C
BUDA TX
78610-2839
US

V. Phone/Fax

Practice location:
  • Phone: 512-838-3118
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code204E00000X
TaxonomyOral & Maxillofacial Surgery (D.M.D.)
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. DERRICK M FLINT
Title or Position: ORAL SURGEON/OWNER
Credential: MD, DDS
Phone: 415-794-7788