NPIMap

Organization Active NPI

Sarrell Regional Dental Center for Public Health, Inc.

  • Pediatric Dentistry
  • Foley, AL
National Provider Identifier
1013304310
Registry record updated Feb 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
SARRELL REGIONAL DENTAL CENTER FOR PUBLIC HEALTH, INC.
Practice address
805 N McKenzie St
Suite C
Foley, AL 36535-3544
Phone
(251) 943-1189
Fax
(251) 943-1655
NPI assigned
Apr 24, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2016

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

Authorized official

Name
Todd Cruse
Title
President
Phone
(629) 999-5006

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X Primary

Addresses

Primary practice location

805 N McKenzie St
Suite C
Foley, AL 36535-3544

Mailing address

230 E 10TH St
Suite 106
Anniston, AL 36207-5784
Phone (256) 741-7340

Other identifiers 1

IdentifierTypeStateIssuer
172190MedicaidAL

National Provider Directory

National Provider Directory
Tax ID family
Advantage Dental Oral Health and Vision Center of Alabama PC31 organizations share this tax ID, including this one

Other organizations with this tax ID 30

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

View all 30

Locations

805 N McKenzie St
#C
Foley, AL 36535
Phone (251) 943-1189

NPI Registry JSON

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

{
    "created_epoch": "1429833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456272000000",
    "number": "1013304310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 E 10TH ST",
            "address_2": "SUITE 106",
            "city": "ANNISTON",
            "state": "AL",
            "postal_code": "362075784",
            "telephone_number": "256-741-7340",
            "fax_number": "256-741-7373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 N MCKENZIE ST",
            "address_2": "SUITE C",
            "city": "FOLEY",
            "state": "AL",
            "postal_code": "365353544",
            "telephone_number": "251-943-1189",
            "fax_number": "251-943-1655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SARRELL REGIONAL DENTAL CENTER FOR PUBLIC HEALTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-24",
        "last_updated": "2016-02-24",
        "status": "A",
        "authorized_official_last_name": "CRUSE",
        "authorized_official_first_name": "TODD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "629-999-5006"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "172190",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Foley, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2016; 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.