Pediatric Dental Associates of Hoover, LLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

PEDIATRIC DENTAL ASSOCIATES OF HOOVER, LLC

Doing business as

PDA of Hoover, LLC

Practice address

5336 Stadium Trace Pkwy Ste 112
Hoover, AL 35244-4581

Phone

(205) 988-9678

NPI assigned

Apr 21, 2022

Organization subpart

No

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

Authorized official

Name

Benjamin Earl Samuelson, DMD, MS

Title

Orthodontist/Owner

Phone

(205) 910-0143

Specialties & licenses 1

Addresses

Other names 1

• PDA of Hoover, LLC Doing business as

Locations

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

{
    "created_epoch": "1650499200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650499200000",
    "number": "1043954647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5336 STADIUM TRACE PKWY STE 112",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352444581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5336 STADIUM TRACE PKWY STE 112",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352444581",
            "telephone_number": "205-988-9678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC DENTAL ASSOCIATES OF HOOVER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-21",
        "last_updated": "2022-04-21",
        "certification_date": "2022-04-21",
        "status": "A",
        "authorized_official_last_name": "SAMUELSON",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_middle_name": "EARL",
        "authorized_official_title_or_position": "ORTHODONTIST/OWNER",
        "authorized_official_telephone_number": "205-910-0143",
        "authorized_official_credential": "DMD, MS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PDA of Hoover, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Paul V Barganier, DMD, PC
• Pda Orthodontics, LLC (Medplex Pediatric Dentistry)
• D. Sue Pearson, LPC
• Kandice Kelley Pearson, M.S. CCC-SLP
• Brantley Peddy
• Pedorthic Care, LLC
• Ashley Peek, CRNP
• Carmen Peeler
• Jacob Pender
• Perdue Counseling & Consultation, LLC (Perdue Counseling & Consulting, LLC)

• Pediatric Dentistry in Hoover, AL
• Providers in Hoover, AL by specialty
• Pediatric Dentistry in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 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.