NPIMap

Organization Active NPI

Stonecreek Dental of Alabama

  • Dental Clinic/Center
  • Prattville, AL
National Provider Identifier
1003568411
Registry record updated Jan 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
STONECREEK DENTAL OF ALABAMA
Practice address
711 Kornegay Dr
Prattville, AL 36066-7715
Phone
(334) 285-7111
NPI assigned
Jan 26, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2022

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

Authorized official

Name
Veronica Jackson
Title
Revenue Cycle Manager
Phone
(205) 919-1750

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

711 Kornegay Dr
Prattville, AL 36066-7715

Mailing address

711 Kornegay Dr
Prattville, AL 36066-7715

Other identifiers 1

IdentifierTypeStateIssuer
0000OtherNONE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address veronicajackson@stonecreekdentalcare.com

National Provider Directory

National Provider Directory
Tax ID family
Stonecreek Dental of Alabama26 organizations share this tax ID, including this one

Other organizations with this tax ID 25

Organizations that report the same tax identification number in the National Provider Directory.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1643155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643155200000",
    "number": "1003568411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 KORNEGAY DR",
            "city": "PRATTVILLE",
            "state": "AL",
            "postal_code": "360667715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 KORNEGAY DR",
            "city": "PRATTVILLE",
            "state": "AL",
            "postal_code": "360667715",
            "telephone_number": "334-285-7111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STONECREEK DENTAL OF ALABAMA",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-26",
        "last_updated": "2022-01-26",
        "certification_date": "2022-01-26",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "VERONICA",
        "authorized_official_title_or_position": "REVENUE CYCLE MANAGER",
        "authorized_official_telephone_number": "205-919-1750"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NONE",
            "identifier": "0000",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "veronicajackson@stonecreekdentalcare.com",
            "affiliation": "N",
            "address_1": "711 Kornegay Dr",
            "city": "Prattville",
            "state": "AL",
            "country_code": "US",
            "postal_code": "360667715",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Prattville, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 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.