Provider Demographics
NPI:1891289179
Name:ROMERO, COREY STEVEN (DDS)
Entity type:Individual
Prefix:DR
First Name:COREY
Middle Name:STEVEN
Last Name:ROMERO
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 1:4100 E 51ST ST STE 300
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78723-4767
Mailing Address - Country:US
Mailing Address - Phone:512-737-6648
Mailing Address - Fax:
Practice Address - Street 1:3313 RANCH ROAD 620 S STE 300
Practice Address - Street 2:
Practice Address - City:LAKEWAY
Practice Address - State:TX
Practice Address - Zip Code:78738-6871
Practice Address - Country:US
Practice Address - Phone:512-255-5900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-19
Last Update Date:2025-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX361311223X0400X
MADN18579561223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics