NPIMap

Organization Active NPI

Advanced Aesthetics Dental Center and Spa

  • Dentist
  • Gulf Shores, AL
National Provider Identifier
1154634954
Registry record updated Jul 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
5312 Issued in AL
Legal business name
ADVANCED AESTHETICS DENTAL CENTER AND SPA
Practice address
350 Cypress Bend Blvd Ste 102
Gulf Shores, AL 36542-2773
Phone
(251) 967-1144
NPI assigned
Jul 21, 2010
Last updated
Jul 21, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2010

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

Authorized official

Name
Dr. Tracie M Battle, D.M.D.
Title
President
Phone
(251) 967-1179

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 5312 AL Primary

Addresses

Primary practice location

350 Cypress Bend Blvd Ste 102
Gulf Shores, AL 36542-2773

Mailing address

PO Box 852073
Mobile, AL 36685-2073
Phone (251) 967-1179

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1279670400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1279670400000",
    "number": "1154634954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 852073",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366852073",
            "telephone_number": "251-967-1179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 CYPRESS BEND BLVD STE 102",
            "city": "GULF SHORES",
            "state": "AL",
            "postal_code": "365422773",
            "telephone_number": "251-967-1144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED AESTHETICS DENTAL CENTER AND SPA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-21",
        "last_updated": "2010-07-21",
        "status": "A",
        "authorized_official_last_name": "BATTLE",
        "authorized_official_first_name": "TRACIE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "251-967-1179",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AL",
            "license": "5312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gulf Shores, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.