NPIMap

Organization Active NPI

Pine Belt Dental LLC

  • General Practice Dentistry
  • Grove Hill, AL
National Provider Identifier
1144588906
Registry record updated Apr 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
AL3287 Issued in AL
Legal business name
PINE BELT DENTAL LLC
Practice address
297C S Jackson St
Grove Hill, AL 36451-3231
Phone
(251) 275-3822
Fax
(251) 275-4190
NPI assigned
Apr 30, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2012

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

Authorized official

Name
Dr. Jimmy C White, DMD
Title
General Partner
Phone
(251) 275-3822

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X AL3287 AL Primary

Addresses

Primary practice location

297C S Jackson St
Grove Hill, AL 36451-3231

Mailing address

297C S Jackson St
P O Box 129
Grove Hill, AL 36451-3231
Phone (251) 275-3822

Other identifiers 2

IdentifierTypeStateIssuer
1962737916OtherALNATIONAL PROVIDER IDENTIFIER
1558445999OtherALNATIONAL PROVIDER IDENTIFIER

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1335744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335744000000",
    "number": "1144588906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "297C S JACKSON ST",
            "address_2": "P O BOX 129",
            "city": "GROVE HILL",
            "state": "AL",
            "postal_code": "364513231",
            "telephone_number": "251-275-3822",
            "fax_number": "251-275-4190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "297C S JACKSON ST",
            "city": "GROVE HILL",
            "state": "AL",
            "postal_code": "364513231",
            "telephone_number": "251-275-3822",
            "fax_number": "251-275-4190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINE BELT DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-30",
        "last_updated": "2012-04-30",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "JIMMY",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "GENERAL PARTNER",
        "authorized_official_telephone_number": "251-275-3822",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "AL3287",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONAL PROVIDER IDENTIFIER",
            "identifier": "1962737916",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONAL PROVIDER IDENTIFIER",
            "identifier": "1558445999",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grove Hill, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2012; 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.