NPIMap

Organization Active NPI

Stonecreek Dental of Alabama

  • Dental Clinic/Center
  • Birmingham, AL
National Provider Identifier
1114656303
Registry record updated Jun 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
STONECREEK DENTAL OF ALABAMA
Practice address
4702 Misty Ridge Cir
Birmingham, AL 35235-8665
Phone
(205) 853-1136
NPI assigned
Jun 6, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2022

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

Authorized official

Name
Veronica Jackson
Title
Revenue Cycle Manager
Phone
(205) 919-1750

Specialties & licenses 1

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

Addresses

Primary practice location

4702 Misty Ridge Cir
Birmingham, AL 35235-8665

Mailing address

4702 Misty Ridge Cir
Birmingham, AL 35235-8665
Phone (205) 853-1136

Other names 1

  • MST DENTAL Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address manager@trussvilledentist.com

National Provider Directory

National Provider Directory
Tax ID family
Stonecreek Dental of Alabama26 organizations share this tax ID, including this one

Other organizations with this tax ID 25

Organizations that report the same tax identification number in the National Provider Directory.

View all 25

Locations

4702 Misty Ridge Cir
Birmingham, AL 35235
Phone (205) 769-6238

NPI Registry JSON

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

{
    "created_epoch": "1654473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654473600000",
    "number": "1114656303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4702 MISTY RIDGE CIR",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352358665",
            "telephone_number": "205-853-1136",
            "fax_number": "205-769-6245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4702 MISTY RIDGE CIR",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352358665",
            "telephone_number": "205-853-1136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STONECREEK DENTAL OF ALABAMA",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-06",
        "last_updated": "2022-06-06",
        "certification_date": "2022-05-26",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "VERONICA",
        "authorized_official_title_or_position": "REVENUE CYCLE MANAGER",
        "authorized_official_telephone_number": "205-919-1750"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "manager@trussvilledentist.com",
            "affiliation": "N",
            "address_1": "4702 Misty Ridge Cir",
            "city": "Birmingham",
            "state": "AL",
            "country_code": "US",
            "postal_code": "352358665",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "MST DENTAL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Birmingham, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2022; 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.