Healthcare Provider Details

I. General information

NPI: 1629990189
Provider Name (Legal Business Name): SKYLAR BADON DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3613 WILLIAMS DR STE 1001
GEORGETOWN TX
78628-1376
US

IV. Provider business mailing address

509 BARTON RUN DR
GEORGETOWN TX
78628-3878
US

V. Phone/Fax

Practice location:
  • Phone: 512-863-0468
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number42549
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: