NPIMap

Organization Active NPI

Burntshirt LLC

  • Dental Clinic/Center
  • Montgomery, AL
National Provider Identifier
1023976560
Registry record updated Jan 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
BURNTSHIRT LLC
Practice address
3525 Young Meadows Rd
Montgomery, AL 36116-1114
Phone
(334) 277-2332
NPI assigned
Jan 13, 2026
Last updated
Jan 13, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2026

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

Authorized official

Name
Dr. Samantha Freeman Rolen, DMDNPI 1790217263
Title
Owner
Phone
(334) 277-2332

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

3525 Young Meadows Rd
Montgomery, AL 36116-1114

Mailing address

3525 Young Meadows Rd
Montgomery, AL 36116-1114
Phone (334) 277-2332

National Provider Directory

National Provider Directory

Locations

3525 Young Meadows Rd
Montgomery, AL 36116
Phone (334) 277-2332

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1768262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768262400000",
    "number": "1023976560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3525 YOUNG MEADOWS RD",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361161114",
            "telephone_number": "334-277-2332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3525 YOUNG MEADOWS RD",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361161114",
            "telephone_number": "334-277-2332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BURNTSHIRT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-01-13",
        "last_updated": "2026-01-13",
        "certification_date": "2026-01-13",
        "status": "A",
        "authorized_official_last_name": "ROLEN",
        "authorized_official_first_name": "SAMANTHA",
        "authorized_official_middle_name": "FREEMAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "334-277-2332",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2026; 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.