SOUTHERN PERIODONTICS II, P.C. (NPI# 1861986622) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861986622 |
| Entity Type | Organization |
| Organization Name | SOUTHERN PERIODONTICS II, P.C. |
| Other Organization Name | SOUTHERN PERIODONTICS |
| Practice Address |
1023 Oxmoor Rd Homewood AL 35209-5317 |
| Practice Telephone | 2564673638 |
| Mailing Telephone | 2564673638 |
| Enumeration Date | 2018-06-15 |
| Last Update Date | 2018-06-15 |
| Authorized Official Name | DR. COTY HULGAN (PRESIDENT) |
| Authorized Official Telephone | 2564673638 |
| Authorized Official Credential | DMD, MPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
6124 | AL | Dental Providers |
| Other Name | Type Code |
|---|---|
| Southern Periodontics | Doing Business As Name - Organization |
| Street Address |
1023 OXMOOR RD |
| City | HOMEWOOD |
| State | AL |
| Zip Code | 35209-5317 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437793510 | Marissa M Mcintyre | Registered Nurse | 3401 Independence Drive, Suite 221, Birmingham, AL 35209 | 2019-11-01 |
| 1093284457 | Patriot Healthcare of Alabama, LLC | Family Medicine | 2045 Brookwood Medical Center Drive, Suite 1, Birmingham, AL 35209 | 2018-11-15 |
| 1164902268 | Lucy Johnston | Physician Assistant | 1602 Woodfern Dr, Homewood, AL 35209 | 2018-08-17 |
| 1881184646 | Wade Louis Grady | Specialist/Technologist | 800 Larkshore Drive, Birmingham, AL 35209 | 2018-05-16 |
| 1154823029 | Taylor Payne | Physical Medicine & Rehabilitation | 109 Devon Dr, Birmingham, AL 35209 | 2018-03-06 |
| 1396251542 | 1st America Infusion Services LLC | Durable Medical Equipment & Medical Supplies | 120 Oxmoor Blvd Ste 100, Birmingham, AL 35209 | 2017-12-26 |
| 1376060954 | Hannah Holloway | Specialist/Technologist | 725 Crest Lane, Birmingham, AL 35209 | 2017-08-24 |
| 1558887463 | Paul A Rhodes | Nurse Practitioner | 631 Beacon Center Office Park, Suite 108, Birmingham, AL 35209 | 2017-08-22 |
| 1538542196 | Proteus Molecular and Clinical Lab LLC | Clinical Medical Laboratory | 218 Summit Pkwy, Suite 250, Homewood, AL 35209 | 2015-07-01 |
| 1124407739 | Randall Alban | Nurse Practitioner | 2100 Southbridge Parkway, Suite 650, Birmingham, AL 35209 | 2015-05-28 |
| Find all providers in zip 35209 | ||||
| Taxonomy Code | 1223P0300X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Periodontics |
| That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710922752 | Devang Tulsidas Thakkar | Dentist | 18130 Halsted St, Homewood, IL 60430-2507 | 2006-06-16 |
| 1821040239 | Neil Mark Blumenthal | Dentist | 17926 Halsted St, Suite 3nw, Homewood, IL 60430-2029 | 2006-05-16 |
| 1417183369 | The Dental Specialists | Dentist | 18213 Dixie Hwy, Homewood, IL 60430-2205 | 2009-06-05 |
| 1528256534 | Amarik Singh | Dentist | 18130 Halsted St, Homewood, IL 60430-2507 | 2007-10-04 |
| 1407044415 | Donald A. Miller | Dentist | 18130 Halsted St, Homewood, IL 60430-2507 | 2007-10-04 |
| 1801083423 | John F. Moore | Dentist | 18130 Halsted St, Homewood, IL 60430-2507 | 2007-09-27 |
| 1992992549 | John A. Pyle | Dentist | 18130 Halsted St, Homewood, IL 60430-2507 | 2007-09-27 |
| 1346449162 | Michael Sean Slavin | Dentist | 18130 Halsted St, Homewood, IL 60430-2507 | 2007-07-12 |
| 1013075480 | Endodontic & Periodontic Associates, Ltd | Dentist | 18130 Halsted St, Homewood, IL 60430-2507 | 2006-12-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508489709 | Kevin M. Sims, Dmd, Ms, PC | Dentist | 2074 Valleydale Rd, Hoover, AL 35244-2084 | 2020-05-21 |
| 1619599297 | Alabama Dental Specialist LLC | Dentist | 4501 Southlake Pkwy Ste 201, Hoover, AL 35244-3644 | 2020-05-18 |
| 1467964544 | Jamie Hargett Howard | Dentist | 418 School of Dentistry Building, 1919 7th Ave S, Birmingham, AL 35233 | 2017-10-30 |
| 1770028532 | George Britt | Dentist | 5104 Cyrus Cir, Birmingham, AL 35242-4630 | 2017-01-03 |
| 1407043797 | Jack Holmes Reid Jr. | Dentist | 911 Plantation Blvd, Fairhope, AL 36532-2949 | 2007-10-01 |
| 1568660231 | Scott Edmund Atkinson | Dentist | 621 Helen Keller Blvd Ste 200, Tuscaloosa, AL 35404-2962 | 2007-07-04 |
| 1396947818 | Maria L Geisinger | Dentist | 121 Peachtree Rd, Birmingham, AL 35213-2930 | 2007-06-05 |
| 1790812030 | John M. Lane | Dentist | 1912 Bruin Dr, Florence, AL 35630-6769 | 2007-02-27 |
| 1134280712 | Brett Maddux | Dentist | 3240 Edwards Lake Pkwy Ste 200, Birmingham, AL 35235-3128 | 2006-12-13 |
| 1154489409 | George N Britt Dmd Pa | Dentist | 5104 Cyrus Circle, Birmingham, AL 35242 | 2006-12-05 |
| 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.