PEDIATRIC DENTAL ASSOCIATES, LLC (NPI# 1700056124) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700056124 |
| Entity Type | Organization |
| Organization Name | PEDIATRIC DENTAL ASSOCIATES, LLC |
| Practice Address |
2806 Dr John Haynes Dr Ste B Pell City AL 35125-1485 |
| Practice Telephone | 2053384227 |
| Practice Fax Number | 2053384204 |
| Mailing Telephone | 2053384227 |
| Mailing Fax Number | 2053384204 |
| Enumeration Date | 2008-03-03 |
| Last Update Date | 2008-03-03 |
| Authorized Official Name | DR. RICHARD B CHAMBLISS JR. (PRESIDENT) |
| Authorized Official Telephone | 2053384227 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
LNO5181 | AL | Dental Providers |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Alabama Business Registrations | Pediatric Dental Associates, LLC |
| Street Address |
2806 DR JOHN HAYNES DR STE B |
| City | PELL CITY |
| State | AL |
| Zip Code | 35125-1485 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477048601 | Rachel York | Occupational Therapist | 2806 Dr John Haynes Dr Ste B, Pell City, AL 35125-1485 | 2018-06-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629507082 | Christoph Scott Koogler | Pharmacist | 165 Vaughn Lane, Pell City, AL 35125 | 2017-06-08 |
| 1104133693 | State of Alabama Department of Public Health | Nurse Practitioner | 1175 23rd Street North, St. Clair County Health Department, Pell City, AL 35125 | 2010-09-07 |
| 1801918776 | David Timothy Sawyer | Dentist | 402a Cogswell Ave, Pell City, AL 35125 | 2007-04-04 |
| 1528106341 | Patricia Yvonne Hamilton | Counselor | 1540 Center Point Pkway, Suite 102, Birmingham, AL 35125 | 2007-02-02 |
| 1316028566 | Glenn Hendrick Magargee | Counselor | 8 16th Street, Pell City, AL 35125 | 2006-10-17 |
| 1508965633 | Derek Matthew Morris | Pharmacist | 505 Martin Street, Pell City, AL 35125 | 2006-09-22 |
| 1699882738 | Hasmukh Nagindas Jariwala | Internal Medicine | 2811 Dr John Haynes Dr, Suite 102, Pell City, AL 35125 | 2006-08-24 |
| 1912914185 | Sara V Thompson | Nurse Practitioner | 70 Plaza Drive, Pell City, AL 35125 | 2006-08-01 |
| 1972547636 | Elisabeth May Douglass | Physical Therapist | 85 Plaza Drive, Pell City, AL 35125 | 2006-06-15 |
| 1851376610 | Barry G Collins | Internal Medicine | 7067 Veterans Parkway, Suite 200, Pell City, AL 35125 | 2005-12-14 |
| Find all providers in zip 35125 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801423280 | Otm Pediatric Dentistry, LLC | Dentist | 521 Highway 31 S Ste 125, Vestavia Hills, AL 35216-1877 | 2020-03-25 |
| 1629602529 | Summit Smiles Pediatric Dentistry, LLC | Dentist | 3106 James Madison Dr E, Mobile, AL 36693-4060 | 2020-02-28 |
| 1316453210 | Liberty Park Children's Dentistry | Dentist | 1950 Stonegate Dr Ste 100, Vestavia Hls, AL 35242-2525 | 2017-12-14 |
| 1578091815 | Bush Pediatric Dentistry | Dentist | 4740 Woodmere Blvd, Montgomery, AL 36106-3065 | 2017-05-31 |
| 1225415771 | Oxford Pediatric Dental Associates LLC | Dentist | 1409 Hamric Dr E, Oxford, AL 36203-1933 | 2015-05-05 |
| 1013304310 | Sarrell Regional Dental Center for Public Health, Inc. | Dentist | 805 N Mckenzie St, Suite C, Foley, AL 36535-3544 | 2015-04-24 |
| 1962813188 | Shelby Pediatric Dentistry, PC | Dentist | 2490 Pelham Parkway, Pelham, AL 35124 | 2014-05-09 |
| 1447681861 | Mobile Pediatric Dentistry | Dentist | 1105 Hillcrest Rd Ste B, Mobile, AL 36695-3921 | 2013-12-11 |
| 1659635712 | Natasha Varma | Dentist | 9807 Mcsara Ct, Spanish Fort, AL 36527-5461 | 2012-07-03 |
| 1407133978 | Sarrell Regional Dental Center for Public Health Inc. | Dentist | 1572 Mill Sq, Alexander City, AL 35010-3367 | 2011-11-10 |
| 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.