NPIMap

Organization Active NPI

Periodontal and Implant Associates, Inc.

  • Periodontics
  • Cullman, AL
National Provider Identifier
1174867014
Registry record updated Nov 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
5578 Issued in AL
Legal business name
PERIODONTAL AND IMPLANT ASSOCIATES, INC.
Practice address
212 4TH Ave SE
Suite 500
Cullman, AL 35055-3673
Phone
(256) 734-8588
NPI assigned
Nov 15, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2012

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

Authorized official

Name
Dr. Jennifer H Doobrow, DMDNPI 1295908648
Title
Owner/Periodontist
Phone
(256) 734-8588

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PeriodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0300X 5578 AL Primary

Addresses

Primary practice location

212 4TH Ave SE
Suite 500
Cullman, AL 35055-3673

Mailing address

212 4TH Ave SE
Suite 500
Cullman, AL 35055-3673
Phone (256) 734-8588

National Provider Directory

National Provider Directory

Locations

212 4th Ave SE
Ste 500
Cullman, AL 35055
Phone (256) 734-8588

Practitioners & affiliated clinicians

Practitioners 1

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": "1352937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352937600000",
    "number": "1174867014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 4TH AVE SE",
            "address_2": "SUITE 500",
            "city": "CULLMAN",
            "state": "AL",
            "postal_code": "350553673",
            "telephone_number": "256-734-8588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 4TH AVE SE",
            "address_2": "SUITE 500",
            "city": "CULLMAN",
            "state": "AL",
            "postal_code": "350553673",
            "telephone_number": "256-734-8588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERIODONTAL AND IMPLANT ASSOCIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-15",
        "last_updated": "2012-11-15",
        "status": "A",
        "authorized_official_last_name": "DOOBROW",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER/PERIODONTIST",
        "authorized_official_telephone_number": "256-734-8588",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": "AL",
            "license": "5578",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cullman, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 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.