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General NPI Number Information
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NPI Number | 1528270352
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Entity Type | Individual
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Provider Name | MICHAEL ALLEN CIAVERELLI DDS
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Gender | Male
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Dates
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Enumeration Date | 05/04/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 4029 CAPITAL OF TX HWY S SUITE 109
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City | AUSTIN
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State | TX
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Zip | 78704
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Country | US
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Telephone | 512-445-5866
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Fax |
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Provider Business Mailing Address
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Address Line | 6810 PONCHA PASS
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City | AUSTIN
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State | TX
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Zip | 78749
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Country | US
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Telephone | 512-394-9768
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 21186
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 21186
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License Number State | TX
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