BREWTON DENTAL CARE LLC (NPI# 1790254621) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790254621 |
| Entity Type | Organization |
| Organization Name | BREWTON DENTAL CARE LLC |
| Practice Address |
420 Douglas Ave Brewton AL 36426-2052 |
| Practice Telephone | 2518675625 |
| Practice Fax Number | 2518675648 |
| Mailing Telephone | 2518675625 |
| Mailing Fax Number | 2518675648 |
| Enumeration Date | 2018-11-20 |
| Last Update Date | 2018-11-20 |
| Authorized Official Name | DR. KENNETH WOODWARD JR. (DENTIST) |
| Authorized Official Telephone | 2518675625 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
Ambulatory Health Care Facilities |
| Street Address |
420 DOUGLAS AVE |
| City | BREWTON |
| State | AL |
| Zip Code | 36426-2052 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346393766 | Brian Keith Miller | Dentist | 420 Douglas Ave, Brewton, AL 36426-2052 | 2007-01-19 |
| 1457833972 | B. Keith Miller Dmd, PC | Dentist | 420 Douglas Ave, Brewton, AL 36426-2052 | 2018-08-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013430214 | Rural Urgent Care LLC | Clinic/Center | 2134 Douglas Ave, Brewton, AL 36426 | 2017-07-19 |
| 1063958536 | Nicole Jones | Counselor | 1321 Mcmillan Avenue, Ste A, Brewton, AL 36426 | 2017-01-09 |
| 1225284185 | Mark Herbert Surles | Chiropractor | 217 Belleville Ave, Brewton, AL 36426 | 2008-08-12 |
| 1497972061 | Reese John Robinson | Dentist | 102 Mason St, Brewton, AL 36426 | 2007-04-18 |
| 1265543797 | James Randall Deatherage | Dentist | 422 Douglas Avenue, Brewton, AL 36426 | 2006-08-31 |
| 1053389403 | Andria P Caldwell | Dentist | 1115 Azalea Place, Brewton, AL 36426 | 2006-03-10 |
| 1013043637 | Shai Tanyette Hall | Dentist | 1503 Mcmillan Ave, Brewton, AL 36426-1132 | 2007-02-26 |
| 1700067238 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 2040 Douglas Ave, Brewton, AL 36426-1151 | 2007-11-27 |
| 1487265351 | Nicole Marie Eagle | Pharmacist | 2040 Douglas Ave, Brewton, AL 36426-1151 | 2020-08-13 |
| 1154763092 | Stacy Miles | Pharmacist | 2040 Douglas Ave, Brewton, AL 36426-1151 | 2013-07-19 |
| Find all providers in zip 36426 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093844060 | Tri County Medical Center, Inc | Clinic/Center | 1115 Azalea Pl, Brewton, AL 36426-1318 | 2007-03-05 |
| 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.