NPIMap

Organization Active NPI

Vital Smiles Alabama PC

  • Health Maintenance Organization
  • Mobile, AL
National Provider Identifier
1134421746
Registry record updated Dec 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Maintenance OrganizationTaxonomy code 302R00000X
License
4794 Issued in AL
Legal business name
VITAL SMILES ALABAMA PC
Practice address
2727 Pleasant Valley Rd
Mobile, AL 36606-2162
Phone
(251) 473-5705
NPI assigned
Dec 2, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2010

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

Authorized official

Name
Dr. George David Johnson Jr., DDS
Title
President
Phone
(205) 271-6851

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Maintenance Organization 302R00000X 4794 AL Primary

Addresses

Primary practice location

2727 Pleasant Valley Rd
Mobile, AL 36606-2162

Mailing address

1900 Crestwood Blvd
Suite 211
Irondale, AL 35210-2034
Phone (205) 271-6851

Other names 1

  • Dentaid Dental Center PC Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
The Tooth Zone II Inc8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

NPI Registry JSON

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

{
    "created_epoch": "1291248000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291248000000",
    "number": "1134421746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 CRESTWOOD BLVD",
            "address_2": "SUITE 211",
            "city": "IRONDALE",
            "state": "AL",
            "postal_code": "352102034",
            "telephone_number": "205-271-6851",
            "fax_number": "205-271-6836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2727 PLEASANT VALLEY RD",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366062162",
            "telephone_number": "251-473-5705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITAL SMILES ALABAMA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-02",
        "last_updated": "2010-12-02",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "205-271-6851",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "AL",
            "license": "4794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dentaid Dental Center PC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Mobile, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2010; 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.