NPIMap

Organization Active NPI

Eden Family Dentistry

  • Dentist
  • Pell City, AL
National Provider Identifier
1083023089
Registry record updated Aug 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
4327 Issued in AL
Legal business name
EDEN FAMILY DENTISTRY
Practice address
402 Cogswell Ave
Suite a
Pell City, AL 35125-2446
Phone
(205) 338-2970
Fax
(205) 338-7175
NPI assigned
Aug 5, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2014

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

Authorized official

Name
Mrs. Barbara A Wyatt
Title
Insurance Coordinator
Phone
(205) 338-2970

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 4327 AL Primary

Addresses

Primary practice location

402 Cogswell Ave
Suite a
Pell City, AL 35125-2446

Mailing address

402A Cogswell Ave
Pell City, AL 35125-2446
Phone (205) 338-2970

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1407196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407196800000",
    "number": "1083023089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402A COGSWELL AVE",
            "city": "PELL CITY",
            "state": "AL",
            "postal_code": "351252446",
            "telephone_number": "205-338-2970",
            "fax_number": "205-338-7175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 COGSWELL AVE",
            "address_2": "SUITE A",
            "city": "PELL CITY",
            "state": "AL",
            "postal_code": "351252446",
            "telephone_number": "205-338-2970",
            "fax_number": "205-338-7175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDEN FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-05",
        "last_updated": "2014-08-05",
        "status": "A",
        "authorized_official_last_name": "WYATT",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "INSURANCE COORDINATOR",
        "authorized_official_telephone_number": "205-338-2970",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "AL",
            "license": "4327",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pell City, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2014; 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.