Fairhope Modern Dental, PC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

5616 Issued in AL

Legal business name

FAIRHOPE MODERN DENTAL, PC

Practice address

106 Lottie LN
Fairhope, AL 36532-2995

Phone

(251) 928-0400

NPI assigned

Feb 16, 2018

Last updated

Feb 16, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Andrew Joseph Knight, DMD

Title

President

Phone

(256) 828-0793

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1518739200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1518739200000",
    "number": "1053811067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 LOTTIE LN",
            "city": "FAIRHOPE",
            "state": "AL",
            "postal_code": "365322995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 LOTTIE LN",
            "city": "FAIRHOPE",
            "state": "AL",
            "postal_code": "365322995",
            "telephone_number": "251-928-0400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRHOPE MODERN DENTAL, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-16",
        "last_updated": "2018-02-16",
        "status": "A",
        "authorized_official_last_name": "KNIGHT",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "256-828-0793",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "AL",
            "license": "5616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fairhope Family Medicine, LLC
• Fairhope Gastroenterology, LLC
• Fairhope Health & Rehab, LLC (Fairhope Health & Rehab)
• Fairhope Health & Wellness Center (Healing Touch Chiropractic)
• Fairhope Internal Medicine PC
• Fairhope Pediatric Dentistry, PC
• Fairhope Pediatrics, Inc.
• Fairhope Pharmacy Inc.
• Fairhope Physical Therapy Services, Inc.
• Fairhope Residential LLC

• Dental Clinic/Center in Fairhope, AL
• Providers in Fairhope, AL by specialty
• Dental Clinic/Center in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2018; 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.