NPIMap

Organization Active NPI

Dentistry for Awesome Kids

  • General Practice Dentistry
  • Birmingham, AL
National Provider Identifier
1124565676
Registry record updated Jan 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
DENTISTRY FOR AWESOME KIDS
Practice address
623 8TH Ave W
Birmingham, AL 35204-3604
Phone
(334) 505-0891
NPI assigned
Jan 23, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2017

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

Authorized official

Name
Lauten Johnson
Title
General Dentist
Phone
(205) 447-0202

Specialties & licenses 1

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

Addresses

Primary practice location

623 8TH Ave W
Birmingham, AL 35204-3604

Mailing address

623 8TH Ave W
Birmingham, AL 35204-3604
Phone (334) 505-0891

Other identifiers 2

IdentifierTypeStateIssuer
1114368800MedicaidAL
1992970545MedicaidAL

National Provider Directory

National Provider Directory

Locations

623 8th Ave W
Birmingham, AL 35204
Phone (205) 545-7696

NPI Registry JSON

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

{
    "created_epoch": "1485129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485129600000",
    "number": "1124565676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "623 8TH AVE W",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352043604",
            "telephone_number": "334-505-0891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "623 8TH AVE W",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352043604",
            "telephone_number": "334-505-0891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTISTRY FOR AWESOME KIDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-23",
        "last_updated": "2017-01-23",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "LAUTEN",
        "authorized_official_title_or_position": "GENERAL DENTIST",
        "authorized_official_telephone_number": "205-447-0202"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1114368800",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1992970545",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Jan 23, 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.