Jamila Shani McKinnis Riley, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6830 Issued in AL

Practice address

3805 Airport Blvd
Mobile, AL 36608-1619

Phone

(251) 343-9998

Fax

(337) 828-4717

NPI assigned

Feb 11, 2017

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Addresses

Other identifiers 1

Other names 1

• Jamila Shani McKinnis Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• devoted network organization-d5084670-562f-408b-b100-22a1a4ef4d82
• devoted network organization-25ba88d3-d0a6-4213-84f1-eef6f2b59f68

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Jamila Riley DDS LLC

  • General Practice Dentistry
  • Huntsville, AL
  • NPI 1376405001
  NPD Authorized official
• Jamila Riley DDS LLC

  • Dental Clinic/Center
  • Mobile, AL
  • NPI 1851015275
  NPD Authorized official
• Alex White DDS LLC

  • Dental Clinic/Center
  • Mobile, AL
  • NPI 1093233702
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1486771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654041600000",
    "number": "1003354929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3805 AIRPORT BLVD",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366081619",
            "telephone_number": "251-343-9998",
            "fax_number": "337-828-4717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3805 AIRPORT BLVD",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366081619",
            "telephone_number": "251-343-9998",
            "fax_number": "337-828-4717"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1115 Weber St",
            "address_purpose": "LOCATION",
            "city": "Franklin",
            "state": "LA",
            "postal_code": "70538",
            "country_code": "US",
            "telephone_number": "337-828-2550 x2144",
            "fax_number": "337-828-4717",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5361 NW 22nd Ave",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331428035",
            "country_code": "US",
            "telephone_number": "251-622-6504",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RILEY",
        "first_name": "JAMILA",
        "middle_name": "SHANI MCKINNIS",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-02-11",
        "last_updated": "2022-06-01",
        "certification_date": "2022-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "6907",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN23187",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "6830",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2485130",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAMILA",
            "last_name": "MCKINNIS",
            "middle_name": "SHANI",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jennica Riis, MD
• Nicole Bounds Riis, AUD
• Alexis Kathleen Riley
• Cameron W. Riley, PT
• Christopher Kent Riley, DMD
• Maigan Riley
• Tatianne Riley, CRNP
• David Ringers
• Carolyn Ringhoffer, M.D.
• Allison Breedlove Ringo, PHARMD

• General Practice Dentistry in Mobile, AL
• Providers in Mobile, AL by specialty
• General Practice Dentistry in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.