PEDIATRIC DENTAL ASSOCIATES OF CULLMAN, LLC (NPI# 1609374164) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609374164 |
| Entity Type | Organization |
| Organization Name | PEDIATRIC DENTAL ASSOCIATES OF CULLMAN, LLC |
| Other Organization Name | NASSETTA PEDIATRIC DENTISTRY |
| Practice Address |
1705 Main Ave Sw Ste A Cullman AL 35055-7207 |
| Practice Telephone | 2567396000 |
| Mailing Telephone | 2567396000 |
| Enumeration Date | 2018-01-30 |
| Last Update Date | 2018-01-30 |
| Authorized Official Name | DR. RICHARD CHAMBLISS (OWNER) |
| Authorized Official Telephone | 2054530314 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
0005181 | AL | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Nassetta Pediatric Dentistry | Doing Business As Name - Organization |
| Street Address |
1705 MAIN AVE SW STE A |
| City | CULLMAN |
| State | AL |
| Zip Code | 35055-7207 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619142270 | Patrick Conrad Nassetta | Dentist | 1705 Main Ave Sw Ste A, Cullman, AL 35055-7207 | 2008-04-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013482694 | Timothy Brett Hunt | Counselor | 1912 Commerce Avenue Nw, Cullman, AL 35055 | 2018-10-10 |
| 1073017919 | Kaitlin Roberts | Occupational Therapist | 1640 2nd Ave Sw, Cullman, AL 35055 | 2018-03-23 |
| 1922514488 | Dialysis Clinic Inc | Clinic/Center | 208 Broadway Drive, Sw, Cullman, AL 35055 | 2017-12-20 |
| 1447789870 | Alexis Lindsey | Specialist | 1909 Commerce Avenue Nw, Cullman, AL 35055 | 2017-06-08 |
| 1003297144 | Thomas Ricky Cosper | Counselor | 1528 Peachtree Lane Ste #104, Cullman, AL 35055 | 2015-06-15 |
| 1053574434 | Joshua Michael Robinson | Dentist | 1851 Main Ave Se, Suite A, Cullman, AL 35055 | 2008-07-07 |
| 1902088206 | Dr Henry S Beeler | Family Medicine | 1900 Main Ave, Ste 3, Cullman, AL 35055 | 2007-11-29 |
| 1982896627 | Ronald Wilson Carter | Dentist | 305 6th Ave Se, Cullman, AL 35055 | 2007-08-16 |
| 1710048640 | Home Oxygen Inc | Durable Medical Equipment & Medical Supplies | 408 2nd Avenue Nw, Suite B, Cullman, AL 35055 | 2006-12-13 |
| 1912071150 | Econo Med Inc | Pharmacy | 1824 Main Avenue Sw, Cullman, AL 35055 | 2006-11-20 |
| Find all providers in zip 35055 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417554072 | Dr. Matt Dellinger, Dmd,llc | Clinic/Center | 210 Main Ave Nw, Cullman, AL 35055-2896 | 2020-10-07 |
| 1528628161 | Paul Dudley Freeman Estate Beth Mullins Freeman Adm | Clinic/Center | 1541 3rd St Ne, Cullman, AL 35055-2052 | 2019-06-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871192476 | Jacob L Turner Dmd PC | Clinic/Center | 100 A Andrew Street, Albertville, AL 35950 | 2020-10-23 |
| 1538775150 | Grants Mill Family Dentistry, LLC | Clinic/Center | 1024 Grants Mill Rd, Irondale, AL 35210-2108 | 2020-09-18 |
| 1164035341 | William M Colburn Dmd PC | Clinic/Center | 2810 20th Ave Ste A, Northport, AL 35476-3835 | 2020-08-26 |
| 1689295339 | Liles Family Dentistry, LLC | Clinic/Center | 2234 Ogletree Village Ln, Auburn, AL 36830-2967 | 2020-05-05 |
| 1184251100 | Big Wave Dentistry LLC | Clinic/Center | 110 S Alston St, Foley, AL 36535-1912 | 2020-03-27 |
| 1952934226 | Red Mountain Pediatric Dentistry | Clinic/Center | 2836 Lakeshore Pkwy, Birmingham, AL 35211-5500 | 2020-02-14 |
| 1467085837 | Brooke Jordan Dds LLC | Clinic/Center | 101 Missionary Rdg Ste 101, Birmingham, AL 35242-5203 | 2020-02-13 |
| 1881225829 | Bell Road Dentistry LLC | Clinic/Center | 2642 Bell Rd, Montgomery, AL 36117-4375 | 2020-01-29 |
| 1477199511 | Kentros Dental LLC | Clinic/Center | [email protected], 1973 Chandalar Drive, Pelham, AL 35124 | 2019-11-25 |
| 1609417195 | Rocket City Dental | Clinic/Center | 112 Lily Flagg Rd Sw Ste B, Huntsville, AL 35802-3040 | 2019-10-05 |
| Find all providers with the same taxonomy | ||||
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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.