OAK PARK DENTAL LLC (NPI# 1134774219) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134774219 |
| Entity Type | Organization |
| Organization Name | OAK PARK DENTAL LLC |
| Practice Address |
98 Oak Park Dr Troy AL 36079-3085 |
| Mailing Address |
Po Box 248 Troy AL 36081-0248 |
| Practice Telephone | 3345668266 |
| Practice Fax Number | 3345667850 |
| Mailing Telephone | 3345668266 |
| Mailing Fax Number | 3345667850 |
| Enumeration Date | 2019-08-06 |
| Last Update Date | 2019-08-06 |
| Authorized Official Name | DR. KENNETH ALLEN BLACKMON JR. (SOLE MEMBER) |
| Authorized Official Telephone | 3345668266 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| Street Address |
98 OAK PARK DR |
| City | TROY |
| State | AL |
| Zip Code | 36079-3085 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255985289 | Zackery Ethan Eades | Dentist | 98 Oak Park Dr, Troy, AL 36079-3085 | 2019-07-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629591060 | Walgreen Co | Pharmacy | 115 Southland Vlg # C, Troy, AL 36079 | 2017-07-18 |
| 1821138413 | Fleming Kirk, LLC | Optometrist | 97 Oak Park Drive, Troy, AL 36079 | 2007-02-06 |
| 1578625125 | Southeast Alabama Rural Health Associates | Clinic/Center | 1412 Elba Hwy, Troy, AL 36079 | 2006-12-13 |
| 1346259314 | Donette Louise Bish | Family Medicine | 1412 Elba Hwy, Troy, AL 36079 | 2006-08-07 |
| 1922018183 | Ben A Smith | Family Medicine | 1412 Elba Hwy, Troy, AL 36079-0000 | 2006-08-09 |
| 1003826249 | Tonya L Richards | Nurse Practitioner | 1412 Elba Hwy, Troy, AL 36079-0000 | 2006-08-09 |
| 1780694943 | Jerry C Roy | Pediatrics | 1412 Elba Hwy, Troy, AL 36079-0000 | 2006-08-09 |
| 1972513059 | John M Blough | Family Medicine | 1412 Elba Hwy, Troy, AL 36079-0000 | 2006-08-09 |
| 1831563527 | Sabrina L Pennington | Specialist | 104 Emily Ct, Troy, AL 36079-2981 | 2015-11-18 |
| 1073985438 | Cherise Renee Crisman | Specialist/Technologist | 105 Dale Dr, Troy, AL 36079-3012 | 2015-10-26 |
| Find all providers in zip 36079 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952924508 | Elizabeth Ann Francis | Dentist | 1930 Prime Ct Ste 101, Troy, OH 45373-8899 | 2020-05-18 |
| 1720621659 | Ao of Troy Pllc | Dentist | 363 W Big Beaver Rd Ste 225, Troy, MI 48084-5242 | 2019-10-23 |
| 1114481678 | Brown Dental Associates Pllc | Dentist | 2025 W Long Lake Rd Ste 110, Troy, MI 48098-4100 | 2019-01-29 |
| 1275008633 | Yan Liang | Dentist | 1355 Peachtree Dr, Troy, MI 48083-5345 | 2018-10-11 |
| 1629591441 | Dina Gianchandani | Dentist | 500 Federal St Ste 300, Troy, NY 12180-2832 | 2017-07-24 |
| 1467999664 | Shirin Fakhri D.d.s. P.C. | Dentist | 2885 E Long Lake Rd, Troy, MI 48085-4100 | 2017-01-25 |
| 1437601283 | Gateway Dental Group, LLC | Dentist | 606 Edwardsville Road, Troy, IL 62294 | 2016-10-27 |
| 1154720191 | Judith A. Purcell | Dentist | 721 Hoosick Road, Troy, NY 12180 | 2014-08-15 |
| 1194133439 | Krupa Patel | Dentist | 3970 Stone Haven Dr, Troy, MI 48084-1510 | 2014-07-30 |
| 1063713246 | Troy Family Dentistry, LLC | Dentist | 128 Professional Parkway, Troy, MO 63379 | 2010-11-04 |
| Find all providers in TROY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.