Crestline Village Dentistry

Primary specialty

DentistTaxonomy code 122300000X

License

5014 Issued in AL

Legal business name

CRESTLINE VILLAGE DENTISTRY

Practice address

244 Country Club Park
Birmingham, AL 35213-4200

Phone

(205) 870-5700

Fax

(205) 870-5699

NPI assigned

Jul 30, 2007

Organization subpart

No

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

Authorized official

Name

Georgia C Jones, D.M.D.

Title

Owner

Phone

(205) 870-5700

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1185753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185753600000",
    "number": "1174713895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "244 COUNTRY CLUB PARK",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352134200",
            "telephone_number": "205-870-5700",
            "fax_number": "205-870-5699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "244 COUNTRY CLUB PARK",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352134200",
            "telephone_number": "205-870-5700",
            "fax_number": "205-870-5699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRESTLINE VILLAGE DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-30",
        "last_updated": "2007-07-30",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "GEORGIA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "205-870-5700",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "AL",
            "license": "5014",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALABAMA DENTAL LICENSE NU",
            "identifier": "5014",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maude Crepault
• Francoise Mouroux Cressman, MD
• Laura Catherine Cresswell
• Crest Home Healthcare of Alabama
• Crestline Anesthesia Associates, P.C.
• Haley Spaulding Crew, CRNP
• Margaret Rogers Crew, CRNP
• Marc Cribbs
• Sarah Cribbs
• Carissa Crider

• Dentist in Birmingham, AL
• Providers in Birmingham, AL by specialty
• Dentist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2007; 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.