Family Dental Care of Dothan, PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4491 Issued in AL

Legal business name

FAMILY DENTAL CARE OF DOTHAN, PC

Practice address

107 Professional LN
Dothan, AL 36303-3875

Phone

(334) 792-5711

Fax

(334) 678-8157

NPI assigned

Oct 26, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Keith A Blackmon, D.D.S.NPI 1629017744

Title

Owner

Phone

(334) 792-5711

Specialties & licenses 1

Addresses

Locations

Practitioners 3

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

• Keith A. Blackmon, D.D.S.

  • General Practice Dentistry
  • Dothan, AL
  • NPI 1629017744
  NPD (past) Authorized official
• Callie Gilbert-Hyma, DMD

  • Dentist
  • Dothan, AL
  • NPI 1497504245
  NPD (past)
• Brandon Snell, D.M.D.

  • General Practice Dentistry
  • Dothan, AL
  • NPI 1821379140
  NPD (past)

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1313625600000",
    "number": "1124103288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 PROFESSIONAL LN",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363033875",
            "telephone_number": "334-792-5711",
            "fax_number": "334-678-8157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 PROFESSIONAL LN",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363033875",
            "telephone_number": "334-792-5711",
            "fax_number": "334-678-8157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY DENTAL CARE OF DOTHAN, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-26",
        "last_updated": "2011-08-18",
        "status": "A",
        "authorized_official_last_name": "BLACKMON",
        "authorized_official_first_name": "KEITH",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "334-792-5711",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "4491",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Khazraj Abbas Fadhil, M.D.
• Christine Carroll Fain, OTRL
• Fairview Clinic, P.C.
• Faith and Therapy, LLC
• David Scott Falconer, D.D.S.
• Family First Chiropractic, LLC
• Family Practice Clinic of Dothan, P.a.
• Stella Faria, DDS
• Amy Denise Farmer, BC-HIS
• Kenneth Eugene Farmer Jr., M.D.

• General Practice Dentistry in Dothan, AL
• Providers in Dothan, AL by specialty
• General Practice Dentistry in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2011; 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.