NPIMap

Organization Active NPI

Bobby L. Raygan Jr. DMD PC

  • General Practice Dentistry
  • Hueytown, AL
National Provider Identifier
1104644830
Registry record updated Oct 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
BOBBY L. RAYGAN JR. DMD PC
Practice address
115 Forest Rd
Hueytown, AL 35023-2410
Phone
(205) 491-4921
Fax
(205) 491-4942
NPI assigned
Oct 1, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2024

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

Authorized official

Name
Dr. Bobby L Raygan II, DMDNPI 1942365036
Title
President
Phone
(205) 491-4921

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

115 Forest Rd
Hueytown, AL 35023-2410

Mailing address

115 Forest Rd
Hueytown, AL 35023-2410
Phone (205) 491-4921

Other practice location 1

303 1st Ave NE
Fayette, AL 35555-2305
Phone (205) 932-5290

National Provider Directory

National Provider Directory

Locations

303 1st Ave NE
Fayette, AL 35555
Phone (205) 932-5290

115 Forest Rd
Hueytown, AL 35023
Phone (205) 491-4921

Practitioners & affiliated clinicians

Practitioners 5

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": "1727740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727740800000",
    "number": "1104644830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 FOREST RD",
            "city": "HUEYTOWN",
            "state": "AL",
            "postal_code": "350232410",
            "telephone_number": "205-491-4921",
            "fax_number": "205-491-4942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 FOREST RD",
            "city": "HUEYTOWN",
            "state": "AL",
            "postal_code": "350232410",
            "telephone_number": "205-491-4921",
            "fax_number": "205-491-4942"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "303 1st Ave NE",
            "address_purpose": "LOCATION",
            "city": "Fayette",
            "state": "AL",
            "postal_code": "355552305",
            "country_code": "US",
            "telephone_number": "205-932-5290",
            "fax_number": "205-932-5290",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BOBBY L. RAYGAN JR. DMD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-01",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "status": "A",
        "authorized_official_last_name": "RAYGAN",
        "authorized_official_first_name": "BOBBY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "205-491-4921",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hueytown, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2024; 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.