NPIMap

Organization Active NPI

Mark E. Love DMD ,PC

  • Dental Clinic/Center
  • Russellville, AL
National Provider Identifier
1063928653
Registry record updated Dec 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
3951 Issued in AL
Legal business name
MARK E. LOVE DMD ,PC
Practice address
510 Engle Dr SE
Russellville, AL 35653-2749
Phone
(256) 332-6073
Fax
(256) 332-6655
NPI assigned
Dec 19, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2017

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

Authorized official

Name
Dr. Mark Edwin Love, DMD
Title
Dentist
Phone
(256) 332-6073

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 3951 AL Primary

Addresses

Primary practice location

510 Engle Dr SE
Russellville, AL 35653-2749

Mailing address

510 Engle Dr SE
Russellville, AL 35653-2749
Phone (256) 332-6073

Other identifiers 1

IdentifierTypeStateIssuer
63-11104550MedicaidAL

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1513641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1513641600000",
    "number": "1063928653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "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"
        },
        {
            "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": "MARK E. LOVE DMD ,PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-19",
        "last_updated": "2017-12-19",
        "status": "A",
        "authorized_official_last_name": "LOVE",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "EDWIN",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "256-332-6073",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "AL",
            "license": "3951",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "63-11104550",
            "state": "AL"
        }
    ],
    "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 Dec 19, 2017; 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.