NPIMap

Organization Active NPI

University Orthodontics LLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Tuscaloosa, AL
National Provider Identifier
1104330950
Registry record updated Nov 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
5557 Issued in AL
Legal business name
UNIVERSITY ORTHODONTICS LLC
Practice address
641 Helen Keller Blvd
Tuscaloosa, AL 35404-2983
Phone
(205) 553-2524
Fax
(205) 553-6617
NPI assigned
Nov 30, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2017

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

Authorized official

Name
Dr. Peter Jason Goltz, DMD MS
Title
Owner/Orthodontist
Phone
(205) 553-2524

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0400X 5557 AL Primary

Addresses

Primary practice location

641 Helen Keller Blvd
Tuscaloosa, AL 35404-2983

Mailing address

641 Helen Keller Blvd
Tuscaloosa, AL 35404-2983
Phone (205) 553-2524

National Provider Directory

National Provider Directory

Locations

641 Helen Keller Blvd
Tuscaloosa, AL 35404
Phone (205) 553-2524

NPI Registry JSON

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

{
    "created_epoch": "1512000000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1512000000000",
    "number": "1104330950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "641 HELEN KELLER BLVD",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354042983",
            "telephone_number": "205-553-2524",
            "fax_number": "205-553-6617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "641 HELEN KELLER BLVD",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354042983",
            "telephone_number": "205-553-2524",
            "fax_number": "205-553-6617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY ORTHODONTICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-30",
        "last_updated": "2017-11-30",
        "status": "A",
        "authorized_official_last_name": "GOLTZ",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "JASON",
        "authorized_official_title_or_position": "OWNER/ORTHODONTIST",
        "authorized_official_telephone_number": "205-553-2524",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD MS"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "AL",
            "license": "5557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tuscaloosa, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 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.