Provider Demographics
NPI:1851829162
Name:PARKER, ADAM NATHANIEL (DDS)
Entity type:Individual
Prefix:DR
First Name:ADAM
Middle Name:NATHANIEL
Last Name:PARKER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1803 POLO RD
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78703-3134
Mailing Address - Country:US
Mailing Address - Phone:865-789-3854
Mailing Address - Fax:
Practice Address - Street 1:1005 W 38TH ST STE 102
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-1042
Practice Address - Country:US
Practice Address - Phone:512-330-4624
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-31
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD114231223P0221X
TX398541223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry