NPIMap

Organization Active NPI

Rousseau Dental Care

  • General Practice Dentistry
  • Russellville, AL
National Provider Identifier
1013016328
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3699 Issued in AL
Legal business name
ROUSSEAU DENTAL CARE
Practice address
510 Engle Dr SE
Russellville, AL 35653-2749
Phone
(256) 332-6073
Fax
(256) 332-6655
NPI assigned
Sep 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Susanne P Hebert
Title
Office Manager
Phone
(256) 332-6073

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 3699 AL Primary

Addresses

Primary practice location

510 Engle Dr SE
Russellville, AL 35653-2749

Mailing address

PO Box 446
Russellville, AL 35653-0446
Phone (256) 332-6073

National Provider Directory

National Provider Directory

Locations

510 Engle Dr SE
Russellville, AL 35653
Phone (256) 332-6073

NPI Registry JSON

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1013016328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 446",
            "city": "RUSSELLVILLE",
            "state": "AL",
            "postal_code": "356530446",
            "telephone_number": "256-332-6073",
            "fax_number": "256-332-6655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 ENGLE DR SE",
            "city": "RUSSELLVILLE",
            "state": "AL",
            "postal_code": "356532749",
            "telephone_number": "256-332-6073",
            "fax_number": "256-332-6655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROUSSEAU DENTAL CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HEBERT",
        "authorized_official_first_name": "SUSANNE",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "256-332-6073"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "3699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Russellville, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.